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International Journal of Environmental... Jan 2021Enzymes in toothpastes can support host immune responses, and thus maintain oral health. This study aimed to investigate gingival health and the plaque-reducing effects...
Enzymes in toothpastes can support host immune responses, and thus maintain oral health. This study aimed to investigate gingival health and the plaque-reducing effects of enzyme-containing toothpastes. A laboratory study tested the antimicrobial potential of different enzyme-containing toothpaste formulations. Two promising formulations (enzyme-containing toothpastes with glucose oxidase and D-glucose with (C+) and without Citrox (C-) Citrox) were investigated in a clinical crossover trial (two slurries: sodium lauryl sulfate-containing (SLS), a toothpaste without SLS (reference), and water). Subjects ( = 20) abstained from toothbrushing for four days and rinsed with a toothpaste slurry. Bleeding on probing (BOP) and plaque indices (PI) were measured. A mixed linear model was used to statistically compare the slurries with respect to BOP and PI change. The in vitro bacterial growth-inhibiting evaluation showed the best results for SLS, followed by C+ and C-. The change in BOP and PI exhibited statistically significant differences to water rinsing (BOP; PI changes in % points (difference of the baseline and post-rinse values: water = 8.8%; 90.0%; C+ = -1.4%; 80.4%; SLS = 1.5%; 72.1%; reference = 0.8%; 77.5%; C- = -1.8%; 75.1%). All slurries exhibited anti-gingivitis and anti-plaque effects, resulting in a prophylactic benefit for limited-access regions during brushing.
Topics: Double-Blind Method; Gingiva; Gingivitis; Humans; Sodium Dodecyl Sulfate; Toothbrushing; Toothpastes
PubMed: 33478112
DOI: 10.3390/ijerph18020835 -
BMC Oral Health Jul 2023Most people's tooth brushing performance is deficient, even when they are encouraged to brush to the best of their abilities. The aim of the present study was to explore... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Most people's tooth brushing performance is deficient, even when they are encouraged to brush to the best of their abilities. The aim of the present study was to explore the nature of this deficit by comparing best-possible vs. as-usual brushing.
METHODS
University students (N = 111) were randomly assigned to receive one of two instructions: "brush your teeth as usual" (AU-instruction) or "brush your teeth to the best of your abilities" (BP-instruction). Video analyses assessed brushing performance. The marginal plaque index (MPI) assessed after brushing was used as an indicator of brushing effectiveness. A questionnaire assessed subjectively perceived oral cleanliness (SPOC).
RESULTS
Participants in the BP group brushed their teeth longer (p = 0.008, d = 0.57) and used interdental devices more often (p < 0.001). No group differences emerged in the distribution of brushing time among surfaces, the percentage of brushing techniques used beyond horizontal scrubbing, or the appropriate use of interdental devices (all p > 0.16, all d < 0.30). Plaque persisted at the majority of the sections of the gingival margins, and the groups did not differ in this respect (p = 0.15; d = 0.22). SPOC values in the BP group were higher than those in the AU group (p = 0.006; d = 0.54). Both groups overestimated their actual oral cleanliness by approximately twofold.
CONCLUSIONS
Compared to their usual brushing effort, study participants increased their effort when asked to brush their teeth in the best possible manner. However, that increase in effort was ineffective in terms of oral cleanliness. The results indicate that people's concept of optimized brushing refers to quantitative aspects (e.g., longer duration, more interdental hygiene) rather than qualitative aspects (e.g., considering inner surfaces and gingival margins, appropriate use of dental floss).
TRIAL REGISTRATION
The study was registered in the appropriate national register ( www.drks.de ; ID: DRKS00017812; date of registration: 27/08/2019 - retrospectively registered).
Topics: Humans; Toothbrushing; Gingivitis; Tooth; Dental Plaque; Dental Plaque Index
PubMed: 37415160
DOI: 10.1186/s12903-023-03127-3 -
American Journal of Public Health May 2004
Topics: Child; Dental Care for Children; Dental Hygienists; History, 20th Century; Humans; Toothbrushing; United States
PubMed: 15117686
DOI: 10.2105/ajph.94.5.721 -
BMC Oral Health Jun 2021Toothbrushing is an important yet neglected behaviour that affects the oral health of preschool children. Little is reported on parental supervision, an essential aspect...
BACKGROUND
Toothbrushing is an important yet neglected behaviour that affects the oral health of preschool children. Little is reported on parental supervision, an essential aspect of routine effective toothbrushing in this age group. The aim of this study was to evaluate pre-schoolers' toothbrushing behaviour including parental involvement and its association with their oral health.
METHODS
This was a cross-sectional study. A total of 92 preschool children (4-6 years) were invited to participate with their parents/guardians. Nine parameters of toothbrushing behaviour were assessed from parental responses (questionnaire) and observation of child and parents/guardians (video recording). Oral examination included recording plaque, gingival and dental caries indices. BORIS software was used to assess toothbrushing parameters and Smart PLS was used to perform association with a second-generation multivariate analysis to create models with and without confounding factors.
RESULTS
Girls were slightly more (53%) than boys (47%). Children aged 4 years were slightly more in number (38%), followed by 6-year-olds and 5-year-olds. Nearly, 90% parents had tertiary education and 46% had more than 2 children. Differences were recorded in the reported and observed behaviour. Thirty-five percent parents/guardians reported using pea-size toothpaste amount but only 28% were observed. Forty percent reported to brush for 30 s-1 min, however 51% were observed to brush for 1-2 min. Half the children were observed to use fluoridated toothpaste (F < 1000 ppm) under parental supervision (11%). The mean (SD) plaque score reduction after toothbrushing was 10.80 (2.46), mean pre-brushing plaque score was 90.3 (10.2), mean gingival index was 0.89 (0.65) and mean dental caries status (ICDAS) was 18.87 (12.39). Toothbrushing behaviour in terms of toothbrushing technique, duration, pattern and frequency, toothbrush type and grip type, toothpaste type and amount, post-brushing mouth rinsing and parental involvement contributed significantly to plaque score change (86%), dental caries status (73%), gingival index (66%) and pre-brushing plaque score (31%). The significant confounding variables had a small influence on oral health of preschool children.
CONCLUSIONS
Preschool children's toothbrushing behaviour was inadequate while their oral health was poor, with a significant association between the two parameters.
Topics: Child; Child, Preschool; Cross-Sectional Studies; Dental Caries; Dental Plaque; Female; Humans; Male; Oral Health; Toothbrushing
PubMed: 34078349
DOI: 10.1186/s12903-021-01643-8 -
Brazilian Oral Research 2022Fine motor skills (FMS) allow for the control and coordination of the distal musculature of hands and fingers, a skill required to brush teeth. The objective of this...
Fine motor skills (FMS) allow for the control and coordination of the distal musculature of hands and fingers, a skill required to brush teeth. The objective of this study was to investigate the association between FMS and toothbrushing efficacy. This cross-sectional study included 42 low-income Latino children aged 5 to 9 years from Pasto, Colombia. Toothbrushing efficacy was determined by the children's dental plaque Quigley-Hein Index (QH-I) mean-score difference from before and after toothbrushing. FMS were evaluated using the 5-15R parent evaluation, the spiral drawing Archimedes test, and a neurodevelopmental assessment of movements and prehension patterns during toothbrushing. A descriptive analysis was performed to assess the characteristics of FMS and children's toothbrushing, and a generalized linear model was used to determine associations between these skills and toothbrushing efficacy. Eighty-six percent of the children had at least one difficulty with FMS, and in 7%, they interfered with daily activities. Fourteen percent presented a moderate pattern in the Archimedes test, and 43% had inefficient prehension patterns. Toothbrushing reduced the QH-I by a mean of 1.45 (SD = 0.78-2.12) (p < 0.001). Toothbrushing efficacy was only significantly associated with age (mean-difference = -0.315, 95%CI: -0.481 to -0.148, p < 0.001). FMS and toothbrushing efficacy were not significantly associated. Other components of fine motor control should be analyzed to understand the kinetics of toothbrushing.
Topics: Cross-Sectional Studies; Humans; Motor Skills; Parents; Toothbrushing
PubMed: 35830146
DOI: 10.1590/1807-3107bor-2022.vol36.0103 -
International Dental Journal Jun 2019Toothbrushing might be associated with the development of soft tissue lesions. This systemic review aimed to examine soft tissue lesions caused by different bristle... (Review)
Review
BACKGROUND
Toothbrushing might be associated with the development of soft tissue lesions. This systemic review aimed to examine soft tissue lesions caused by different bristle stiffnesses and bristle end-shapes in manual toothbrushes in adult individuals.
MATERIALS AND METHODS
Scopus, EMBASE and PubMed databases were searched to find controlled trials that evaluated manual toothbrush bristle stiffness and/or end-shape in regard to soft tissue safety. The grey literature was also included in the search strategy. Two reviewers independently performed the screening, final selection and data extraction. To be included, studies had to have been performed using at least two manual toothbrushes differing in bristle stiffness and/or end-shape, and had to report any adverse effects on oral soft tissues after at least 7 days of follow-up. A meta-ethnography strategy was used for qualitative data synthesis. The Cochrane Collaboration tool was assessed to evaluate the risk of bias.
RESULTS
Thirteen studies were included from the 1,945 initially retrieved. Toothbrush bristle end-shape was investigated in six studies, bristle stiffness in two, and both features were investigated in five studies. Hard-bristle toothbrushes produced more gingival lesions than medium- and soft-bristle brushes. A slight gingival recession width increase was identified in the end-rounded group, compared with the tapered group. Only four studies presented adverse effects as the primary outcome.
CONCLUSION
Soft and extra-soft toothbrushes tend to be safer. Oral soft tissue injuries are similar for both tapered and end-rounded bristles. Further studies investigating adverse effects as a primary outcome are recommended.
Topics: Adult; Controlled Clinical Trials as Topic; Equipment Design; Gingiva; Gingival Recession; Hardness; Humans; Toothbrushing
PubMed: 30152076
DOI: 10.1111/idj.12421 -
International Journal of Environmental... Feb 2021The COVID-19 pandemic has drawn attention to microbial transmission risk via aerosols in dental practice. Demonstration electric toothbrushes are used intra-orally for...
The COVID-19 pandemic has drawn attention to microbial transmission risk via aerosols in dental practice. Demonstration electric toothbrushes are used intra-orally for education. The aim of this investigation was to measure the size of droplets emitted by the brush head of two demonstration oscillating-rotating electric toothbrushes. Measurement of droplet production and size was recorded in vitro using three methods: (1) Malvern Spraytec (LASER particle size measurement device with detectable particle size of 0.1-2500 µm) and brushes mounted on a 3D-printed, two-shell form-fit fixture with a supply of tap water; (2) a DustTrak aerosol measurement device and toothpaste slurry, with brushing simulated in the oral cavity of a phantom head; (3) high-speed visualization in a simulated-use situation in the oral cavity of a phantom head, with individual evaluation of tap water, water with detergent, 70% ethanol, glycerin and toothpaste slurry. Both brushes showed the size of emitted droplets was consistently between 200 and 1200 µm, categorized as splatter (dental aerosols are <50 µm diameter). No significant incremental aerosol-sized matter was detected during toothbrush operation. The high-speed video visualization confirmed only splatter-sized droplets during operation. These findings indicate that oscillating-rotating toothbrushes do not produce aerosol-sized particles during simulated use.
Topics: Aerosols; Dental Equipment; Equipment Design; Toothbrushing; Toothpastes
PubMed: 33652982
DOI: 10.3390/ijerph18052320 -
Australian Dental Journal Jun 2000The aim of this study was to evaluate clinically three commercially available dentifrices and to determine any surface effects on tooth or gingival surfaces. Sixty-four... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
The aim of this study was to evaluate clinically three commercially available dentifrices and to determine any surface effects on tooth or gingival surfaces. Sixty-four participants were included in this study and were allocated randomly to one of four treatment groups by an independent person to ensure the investigators were unaware of the brushing material used. All toothbrushes and dentifrices were distributed by this independent person. The treatment groups were: Group 1--brush with water; Group 2--brush with Colgate (Baking Soda and Peroxide); Group 3--brush with Macleans (Whitening); Group 4--brush with Colgate (Sensation Whitening). All participants were requested to brush both morning and evening in their customary fashion using only the designated toothpaste, or water, for four weeks. All participants were required to use the same toothbrush type. No other oral hygiene products such as mouth rinses or dental floss were used during the trial period. Prior to commencement of the brushing period, all participants received a full clinical examination recording the status of the soft and hard tissues including a gingival index (Löe and Silness) to record gingival condition. A polyvinyl siloxane impression was taken of the six anterior teeth and gingival tissues at the commencement of the trial. After four weeks, a second full clinical examination was made and further silicone impressions were taken of the anterior teeth. All impressions were cast in epoxy resin for investigation with light and electron microscopy. Participants were also asked to answer a questionnaire relating to the toothpaste used. The results of this study indicated that no significant clinical differences were recorded for any dentifrice or water and there was no significant difference in gingival index scores over the four week period. Patient responses to each dentifrice varied according to individual patient preferences and expectations and no consistent findings could be determined. Light and electron microscopy indicated that tooth and gingival surface changes that occurred over the four week period with any of the dentifrices were similar to, and not significantly different from, changes seen with the use of water alone. These results indicate that none of the dentifrices tested was harmful to teeth or soft tissues.
Topics: Adolescent; Adult; Carbamide Peroxide; Dental Impression Technique; Dentifrices; Drug Combinations; Epoxy Resins; Female; Follow-Up Studies; Gingiva; Humans; Hydrogen Peroxide; Male; Microscopy, Electron; Models, Dental; Oral Hygiene Index; Patient Compliance; Periodontal Index; Peroxides; Sodium Bicarbonate; Surveys and Questionnaires; Tooth; Tooth Bleaching; Toothbrushing; Urea; Water
PubMed: 10925508
DOI: 10.1111/j.1834-7819.2000.tb00251.x -
The Bulletin of Tokyo Dental College Mar 2020Many types of interdental instrument, such as dental floss and interdental brushes, can be purchased easily and sell in large numbers. Many studies have compared the...
Many types of interdental instrument, such as dental floss and interdental brushes, can be purchased easily and sell in large numbers. Many studies have compared the effects of such instruments. Few studies have investigated their relationship with regions of residual plaque, however. The purpose of this study was to compare rates of plaque removal from the mesial and distal surfaces of the bilateral maxillary and mandibular premolars and molars among 3 types of interdental instrument: finger-winding-dental floss, holder-type dental floss, and an interdental brush. Prior to the experiment, the artificial teeth in a jaw model were removed for application of artificial plaque. The teeth were then replaced and the model attached to a phantom. An operator brushed the teeth in a posture close to that adopted in actual tooth brushing with each type of instrument, after which the plaque removal rate was compared among them. The rate of plaque removal using finger-winding floss was the highest, although this type of instrument is less easy to hold than the others. The rate with a handle-equipped interdental instrument showed a decrease in some regions, although it is easy to hold. The results of this study suggest that the type of interdental instrument used should differ depending on the region to be cleaned.
Topics: Dental Devices, Home Care; Dental Plaque; Dental Plaque Index; Humans; Molar; Toothbrushing
PubMed: 32074586
DOI: 10.2209/tdcpublication.2019-0005 -
International Journal of Environmental... Nov 2020This retrospective, cross-sectional study evaluated dental records of 1000 healthy children to determine factors associated with plaque, gingivitis, and caries. A...
This retrospective, cross-sectional study evaluated dental records of 1000 healthy children to determine factors associated with plaque, gingivitis, and caries. A logistic model for plaque and gingivitis (mild versus moderate/severe) and caries (yes/no) was carried out separately for each variable using the following potential factors: Age, Gender, Brush Type, Starting Age of Brushing, Brushing Frequency, and Bite Type. Data from 998 children (median age: 4 years, 10 months (range: 2.5-7 years)) were analyzed. Sixty-four percent were manual toothbrush users; 36% were oscillating-rotating electric toothbrush users. For plaque and gingivitis, but not caries, Brush Type was more impactful than Brushing Frequency. Age influenced the severity of plaque and gingivitis, with increases in the odds of having moderate/severe plaque or gingivitis associated with increasing age. The probability of caries increased until approximately age 5 and then decreased until age 7. Oscillating-rotating brush users were more likely to present with less plaque, gingivitis, and caries, with 6.0, 5.1, and 1.4 times greater odds of having mild (versus moderate/severe) plaque, less severe gingivitis, and being caries-free, respectively, than manual brush users. Similarly, brushing twice daily and starting brushing at an earlier age were associated with better oral health outcomes. Children with anterior bite abnormalities had increased odds of developing moderate/severe plaque and gingivitis than children with normal anterior bites. Gender was not a statistically significant factor associated with plaque, gingivitis, or caries. Children's oral health is influenced by toothbrush type, starting age of brushing, compliance with twice-daily brushing, and bite abnormalities.
Topics: Child; Child, Preschool; Cross-Sectional Studies; Dental Caries; Dental Plaque; Female; Gingivitis; Humans; Logistic Models; Male; Retrospective Studies; Single-Blind Method; Toothbrushing
PubMed: 33228082
DOI: 10.3390/ijerph17228595