Comparing plaque removal efficacy of biodegradable toothbrush and nonbiodegradable toothbrush in children of 8-10 years of age: A randomized clinical study.

INTRODUCTION: In the 21st century, we are surrounded by plastic, disposal of which has a detrimental effect on the environment. Around 700 million plastic toothbrushes are sold which contributes to a large portion of plastic waste. To aid in the restoration of the environment, there is a need to replace plastic toothbrushes with recyclable toothbrushes. The purpose of the study was to evaluate and compare the plaque removal efficacy of biodegradable toothbrushes and nonbiodegradable toothbrushes in children 8-10 years of age. METHODOLOGY: Ninety children 8-10 years old from school were included in the study. Toothbrush types to groups A (nonbiodegradable toothbrush, Colgate® Palmolive India Ltd.), B (Biodegradable toothbrush, Bamboo India), and C (Biodegradable toothbrush, Palette™ India) were randomly allocated and plaque score was evaluated using plaque disclosing agent and Turesky Modification of Quigley Hein Index at day 1, 7, and 14. The data were analyzed using unpaired "t" and analysis of variance to find the significance of study parameters between the groups and paired t-test was used to find the significance of study parameters within the group (pre- and postbrushing). RESULTS: The comparison of plaque scores pre- and postbrushing in all groups manifested reduction from day 1 to 14. However, Group B showed a significant reduction of plaque on day 14 with a difference of 0.50 which is statistically significant with a P < 0.001. CONCLUSION: According to the results, it can be concluded that a biodegradable toothbrush has adequate plaque removal efficacy. Therefore, the use of biodegradable toothbrushes can be recommended which will reduce nonbiodegradable waste.

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.

Pilot, open-label, randomized controlled clinical trial evaluating 4 oral hygiene regimens using a manual toothbrush, toothpaste, and mouthwash.

In this prospective pilot study, 84 patients with a history of poor oral hygiene were enrolled in an open-label, interventional, randomized controlled clinical trial. The aim was to provide preliminary clinical data on a new line of oral hygiene products containing a prebiotic and a paraprobiotic based on Lactobacillus plantarum. The recruitment rate and patient satisfaction were analyzed to estimate resources for the future primary study, and descriptive data on rebalancing of the oral microbiota were collected. The population was divided into 5 groups based on the products assigned to the patients: 1, delicate mint toothpaste (n = 20); 2, mint toothpaste (n = 12); 3, mint mouthwash (n = 20); 4, delicate mint toothpaste, mint mouthwash, and an antimicrobial toothbrush (n = 20); and 5, continued use of their usual oral care products and routine (control group; n = 12). The study duration was 28 days. All patients tolerated the products well, and there were no adverse events. The recruitment capability and procedures allowed for a realistic estimation for the future main trial. The products did not cause any changes in tooth color. The participants in group 4, who completed the treatment consisting of delicate mint toothpaste, mint mouthwash, and an antimicrobial toothbrush, reported the greatest reduction in gingival sensitivity (P ≤ 0.000; Wilcoxon signed rank test). Analysis with the Wilcoxon signed rank test revealed that all products induced a statistically significant decrease in plaque (P ≤ 0.002) and a reduction in gingival sensitivity (delicate mint toothpaste, P ≤ 0.005; mint toothpaste, P ≤ 0.015; and mint mouthwash, P ≤ 0.015). All products were effective in stabilizing the oral microbiota. The tested products showed an optimal safety profile and a statistically significant efficacy in reducing gingival sensitivity and plaque. They also stabilized the biodiversity of the oral microbiota, making it less susceptible to microbial fluctuations than the control group. Trial registration: ClinicalTrials.gov (NCT05999175).

Effectiveness of Plaque Removal Using Different Toothbrushes in Children - A Comparative Study.

BACKGROUND: Effective plaque control is essential for improved oral health. Advancements in mechanical plaque removal using toothbrushes still continue. One such sophisticated intervention is the app-based toothbrush, a new innovative technology that helps to track the child's brushing habits. AIM: The aim of this study is to evaluate the plaque removal efficacy of three different toothbrushes in children aged 6-8 years. METHODS: A randomized controlled clinical trial was conducted among primary school children with decayed missing filled teeth (dmft) score of ≤2. Baseline plaque score was collected using Turesky modification of the Quigley and Hein Index 1 week after oral prophylaxis. Children were randomly divided into three groups. Group I received conventional toothbrush (n = 25), group II received powered toothbrush (n = 25), and group III received app-based toothbrush (n = 25). Post-intervention plaque score, toothbrush wear and bite mark scores were done at the 15th, 30th, 45th and 90th day. Participant's opinion on their toothbrushes was evaluated using a questionnaire. RESULTS AND CONCLUSION: App-based toothbrush showed maximum plaque reduction followed by powered and conventional toothbrush. Significant reduction in plaque score was seen at 30th-, 45th- and 90th-day follow-up in group II (<0.001) and group III (<0.001). There was no appreciable difference in the toothbrush wear and bite mark score between the three groups. Children preferred app-based toothbrush in spite of the complex nature of using it.

Comparison of gender identification using exfoliated cells obtained from toothbrush and miswak: A longitudinal study.

Gender identification plays a pivotal role in forensic medicine. Among the various methods used for gender identification, deoxyribose nucleic acid (DNA) based methods are considered accurate. Exfoliated oral mucosal cells that are harvested from oral hygiene aids can be potentially used for gender identification using real-time polymerase chain rection (PCR). The aim of the present longitudinal study is to assess and compare the efficacy of toothbrush and miswak as potential tools to harvest exfoliated cells for gender identification. Forty healthy volunteers were recruited and asked to clean their teeth using new toothbrush and fresh miswak each day for 4 days. Toothbrush and miswak used by the participants were subjected to DNA analysis immediately, 1st, 2nd and 6th month. The absorbance of DNA samples were quantified and gender identification was done by amplification of sex determining gene-Sex determining region Y gene (SRY) and ALT1 genes using real-time PCR. The number of correct and positive identification for samples at various time points were tabulated and subjected to statistical analysis. Post hoc power analysis showed that the study had a power of 93%. Correct and positive gender identification was observed for the samples (100%) obtained using miswak, for tooth brush it reduced to 95%, 80%, and 35% at the end of 1st, 2nd, and 6th month. The differences seen at the end of 2nd month and 6th month were statistically significant. Miswak is a better tool to harvest exfoliated cells for gender identification when compared to a toothbrush. Hence, miswak can serve as a potential tool in forensic medicine for DNA extraction and subsequently victim identification.

Self-determined use of provided powered oral hygiene devices leads to improved gingival health after 1 year: a longitudinal clinical trial.

PURPOSE: Our study aimed to evaluate the long-term concordance and acceptance when using powered devices for everyday oral hygiene routine and gingival health in patients showing papillary bleeding. PATIENTS AND METHODS: Thirty-one participants were recruited at the dental clinic of the University Hospital of Cologne, Germany, over a 6-week duration. At baseline, a standard dental check-up was performed, including oral hygiene indices and documentation of oral hygiene devices used. The study consisted of two consecutive phases: the first (motivational trial) was designed to prove the effectiveness and safety of a microdroplet device and a powered toothbrush compared to dental floss and a manual toothbrush over a period of 4 weeks. The second (observational) phase began with all participants receiving the powered oral homecare devices. Participants were able to use their oral hygiene measures of choice over an unsupervised period of 1 year. All participants were then rescheduled for a routine dental check-up, where oral hygiene indices and oral hygiene devices used were reevaluated. RESULTS: After 1 year, 93.3% of participants stated they performed interdental cleaning on a regular basis (baseline 60.0%). The percentage using a powered toothbrush increased from 41.9% (baseline) to 90.0% after 1 year. Oral hygiene parameters had improved after both the motivational trial and observational phases compared to baseline (papillary bleeding index p = .000; Rustogi Modified Navy Plaque Index p < .05; Quigley-Hein Index p = .000). CONCLUSION: In the long term, participants preferred using powered oral hygiene devices over the gold standard dental floss and manual toothbrush. Improved oral hygiene parameters after 1 year may indicate implementation of newly acquired oral-hygiene skills during the 4-week instruction phase.

Evaluation of dental plaque reduction using microcurrent-emitting toothbrushes in orthodontic patients: a randomized, double-blind, crossover clinical trial.

This study aimed to compare the effectiveness of microcurrent-emitting toothbrushes (MCTs) and ordinary toothbrushes in reducing the dental plaque index (PI) and dental caries activity among orthodontic patients. The evaluation was performed using a crossover study design involving 22 orthodontic patients randomly assigned to the MCT or ordinary toothbrush groups. The participants used the designated toothbrush for 4 weeks and had a 1-week wash-out time before crossover to the other toothbrush. PI (Attin's index) and dental caries activity were measured at baseline and at the end of each 4-week period. Additionally, patients completed questionnaires to assess patient satisfaction for "freshness in mouth" and "cleansing degree." The results showed that the MCT group had a significant reduction in PI (p = 0.009), whereas the ordinary toothbrush group did not (p = 0.595). There was no significant difference in the dental caries activity between the two groups (p > 0.05). Patient satisfaction assessment revealed that 65% patients in the MCT group had more than "fair" experience of freshness, in contrast to 50% of patients in the ordinary toothbrush group. Satisfaction with cleansing degree was similar in both groups. Overall, these findings suggest that MCTs are more effective in reducing dental PI than ordinary toothbrushes.

Surface deterioration of resin composites and enamel after toothbrush simulation with new and used toothbrushes.

PURPOSE: To investigate the effect of toothbrushing with new and used toothbrushes on the surface of resin composites and dental enamel. METHODS: The extracted human incisors were selected after vestibular enamel surfaces (ES) were examined. Disc-shaped specimens of direct composite (DC) and indirect composite (IC) were fabricated. Computer-aided design-computer-aided manufacturing (CAD-CAM) composite blocks (CC) were sliced in 2 mm thickness (n= 8). The surface roughness, gloss, and color were measured. The measurements were performed before and after 3 months of toothbrushing simulation (TBS) for 2,500 circular cycles. The wear index was calculated by using the ImageJ program. The specimens were subjected to an additional 2,500 cycles and the same measurements were repeated. RESULTS: No significant increase in surface roughness values was observed in DC, IC, and CC groups after 3 and 6 months of TBS except in the ES group. The highest change in surface gloss was observed in the DC group. Although the wear index of toothbrushes increased over time, only the increase in the IC group was statistically significant (P= 0.033). CLINICAL SIGNIFICANCE: Changes in surface roughness, gloss, and discoloration of the dental enamel and restorations and wear of toothbrush bristles were increased over time.

A Randomized, Parallel Design Study to Evaluate the Effects of Different Oral Cleaning Modalities on Gingivitis and Plaque After a 6-Week Period of Home Use.

The study objective was to evaluate the effect of different interdental oral cleaning modalities on gingivitis and plaque following a 6-week period of home use. This was a randomized, parallel, examiner-blinded study. Study subjects were routine manual toothbrush (MTB) users with moderate to severe gingivitis, aged 18 to 65 years. Subjects were required to have a gingival bleeding score of ≥1 on at least 50 gingival sites per the Gingival Bleeding Index (GBI) and to have a minimum average plaque score of ≥0.6 per the Rustogi Modified Navy Plaque Index (RMNPI) following a 3- to 6-hour plaque accumulation period. Subjects were randomly assigned to one of four groups based on the oral care cleaning modality: (1) NON group: MTB alone, (2) FLS group: MTB plus string floss, (3) MPF group: MTB plus a Philips® Sonicare® Power Flosser with the Quad Stream nozzle, or (4) PPF group: Philips Sonicare power toothbrush plus the power flosser. Safety and efficacy measures (Modified Gingival Index [MGI], GBI, and RMNPI) were assessed at baseline, 2 weeks, and 6 weeks. The primary efficacy endpoint was the reduction in gingival inflammation from baseline to week 6 as measured by the MGI. A total of 260 subjects were randomized and 256 subjects completed the study. The adjusted mean percent reduction in gingival inflammation from baseline to week 6 was 14.90% for the NON group, 13.16% for the FLS group, 33.51% for the MPF group, and 49.30% for the PPF group. Pairwise comparisons indicated that both the PPF and MPF groups were statistically significantly different from both the NON and FLS groups. In conclusion, use of either the Philips Sonicare power toothbrush with the Philips Sonicare Power Flosser or an MTB with the Philips Sonicare Power Flosser was statistically superior to an MTB alone and an MTB used with string floss in reducing gingival inflammation following 6 weeks of home use.

A Randomized, Parallel Design Study to Compare the Effects of Two Different Interdental Cleaning Modalities on Gingivitis and Plaque After a 4-Week Period of Home Use.

The study objective was to evaluate the effect of two different interdental oral cleaning modalities on gingivitis and plaque following a 4-week period of home use. This was a randomized, parallel, single-blinded study. Subjects were routine manual toothbrush (MTB) users with moderate to severe gingivitis, aged 18 to 65 years. Subjects were required at baseline to have a gingival bleeding score of ≥1 on at least 50 gingival sites per the Gingival Bleeding Index (GBI) and to have an overall plaque score of ≥0.6 per the Rustogi Modified Navy Plaque Index (RMNPI) following a 3- to 6-hour plaque accumulation period. Subjects were randomly assigned to one of three groups based on the oral care cleaning modalities: (1) NON group: MTB alone, (2) IDB group: MTB plus an interdental brush, or (3) MPF group: MTB plus a Philips® Sonicare® Power Flosser with the Quad Stream nozzle. All subjects used the MTB with fluoride toothpaste. Efficacy measures (Modified Gingival Index [MGI], GBI, and RMNPI) and safety were assessed at baseline, 2 weeks, and 4 weeks. The primary efficacy endpoint was the reduction in gingival inflammation from baseline to week 4 as measured by the MGI. A total of 189 subjects were randomized and 186 completed the study. The adjusted mean percent reduction in gingival inflammation from baseline to week 4 was 2.80% for the NON group, 11.32% for the IDB group, and 20.87% for the MPF group. The differences between the MPF group and the NON and IDB groups were statistically significant (.0001). In conclusion, use of the MTB with the Philips Sonicare Power Flosser showed statistically significant benefits compared to an MTB alone and an MTB used with an interdental brush in reducing gingival inflammation following 4 weeks of home use.

A Randomized, Parallel Design Study to Compare the Effects of Different Interdental Cleaning Modalities on Gingivitis and Plaque After a 6-Week Period of Home Use.

The objective of this study was to evaluate the effect of different interdental oral cleaning modalities on gingivitis and plaque following a 6-week period of home use. This was a randomized, four-arm, parallel design clinical trial. Study subjects were manual toothbrush (MTB) users with moderate to severe gingivitis, aged 18 to 65 years. Subjects were required at baseline to have a gingival bleeding score of ≥1 on at least 50 gingival sites per the Gingival Bleeding Index (GBI) and to have an overall plaque score of ≥0.6 per the Rustogi Modified Navy Plaque Index (RMNPI) following a 3- to 6-hour plaque accumulation period. Subjects were randomly assigned to use one of four oral care cleaning modalities: (1) NON group: MTB alone, (2) FLS group: MTB plus string floss, (3) IDB group: MTB plus an interdental brush, or (4) CPF group: MTB plus the Philips® Sonicare® Cordless Power Flosser with the Quad Stream nozzle. Efficacy measures (Modified Gingival Index [MGI], GBI, and RMNPI) and safety were assessed at baseline, 2 weeks, and 6 weeks. The primary efficacy endpoint was the reduction in gingival inflammation from baseline to week 6 as measured by the MGI. Of the 372 subjects randomized in the study, 364 completed a post-baseline MGI evaluation and were included in the analyses. The adjusted mean percent reduction in gingival inflammation from baseline to week 6 was -2.10% for the NON group, 2.82% for the FLS group, 2.60% for the IDB group, and 29.10% for the CPF group. Pairwise comparisons indicated that the CPF group was statistically significantly different from the NON, FLS, and IDB groups (.0001). In conclusion, adjunctive use of the Philips Sonicare Cordless Power Flosser with the Quad Stream nozzle and an MTB showed statistically better results in term of reducing gingival inflammation following 6 weeks of home use when compared to an MTB alone, an MTB used with string floss, and an MTB used with an interdental brush.

The effectiveness of water jet flossing and interdental flossing for oral hygiene in orthodontic patients with fixed appliances: a randomized clinical trial.

BACKGROUND: Orthodontic treatment presents challenges with plaque accumulation around brackets, archwires, and elastics, leading to retained plaque and gingival inflammation. Conventional toothbrushing may not be enough, requiring additional oral hygiene aids like interproximal brushes, dental flosses, and water flossers. Limited research exists on comparing water flossing and interdental flossing in orthodontic patients. Therefore, this study aims to assess their effectiveness in maintaining oral hygiene during active orthodontic treatment. METHODS: A single-blind, randomized, parallel clinical study recruited orthodontic patients with full-mouth brackets and archwires. Thirty participants were randomly assigned to either water jet flossing or interdental flossing groups. All participants were instructed to brush twice daily with a provided toothbrush and toothpaste and use the assigned intervention once daily at night. Clinical measures, including the Gingival Bleeding Index (BI), Plaque Index (PI), and Gingival Index (GI), were recorded at baseline and day 14. Descriptive statistics and statistical tests were performed using SPSS software. RESULTS: The water jet flossing group demonstrated a slightly higher, albeit non-significant, benefit in plaque removal (median difference of 6.79%%, P = 0.279) and bleeding reduction (median difference of 5.21%%, P = 0.172) compared to the interdental flossing group after two weeks. Both groups showed significant reductions in gingival bleeding index and plaque index from baseline to the 2-week follow-up. The interdental flossing group had median mean percentage differences of 16.13%% (plaque index) and 23.57% (gingival bleeding index), while the water jet flossing group had median percentage differences of 21.87% (plaque index) and 32.29% (gingival bleeding index). No significant changes in gingival index grades were observed in either group. CONCLUSION: Both water jet flossing and interdental flossing were effective in reducing plaque accumulation and gingival bleeding among orthodontic patients. While no significant differences were found between the two methods, water jet flossing showed a potential advantage. Further research is needed to validate its effectiveness, assess long-term impact, and understand its benefits for orthodontic patients.

Digital plaque monitoring: An evaluation of different intraoral scanners.

OBJECTIVES: Intraoral scanners (IOS) display disclosed plaque, and the scientific literature has reported that plaque levels can be monitored on intraoral scans using one IOS system (Dexis 3800; control IOS). This study aimed to investigate whether this is also possible with other IOS systems (i700, Primescan, Trios 5; test IOS). MATERIALS AND METHODS: Ten participants (29.6 ± 5.5 years) were enrolled. After plaque accumulation and subsequent toothbrushing, intraoral scans were performed with the control IOS and the three test IOS. All scans were aligned and the vestibular/oral surfaces of the Ramfjord teeth (16, 21, 24, 36, 41, 44) were analysed with automated planimetry using a predefined threshold value. The proportion of pixels assigned to plaque-covered areas was expressed as a percentage of the total number of pixels (P%). We then assessed whether the planimetrically determined plaque-covered areas corresponded to those identified visually. This revealed that a threshold correction (P%corr) was required for approximately 20 % (i700 and Trios 5) to over 65 % (Primescan) of the images. RESULTS: Bland-Altman analysis showed no significant systematic bias and limits of agreement ranging from approximately -20 to +20 P% units, with a tendency towards lower values at higher plaque coverage. Manual correction improved the agreement and halved the limits of agreement. All test IOS could detect a reduction in plaque after brushing, as well as the typical site-dependant plaque distribution patterns. CONCLUSIONS: All test IOS appeared to be suitable for plaque monitoring. Planimetric methods must be adapted to the colour representation of the IOS. CLINICAL SIGNIFICANCE: Plaque monitoring using IOS opens a new field of application in preventive dentistry.

Determinación del pH salival después de la aplicación de aceite ozonizado / Determination of salivary pH after application of ozonated oil

La saliva, compuesta principalmente por 99% de agua y 1% de moléculas orgánicas e inorgánicas, mantiene un rango de pH de 6.0 a 7.5, pero puede verse alterada por ciertos factores. En este estudio se determinó la variación del pH salival, luego de la aplicación tópica manual en mucosa masticatoria y órganos dentarios con aceite de girasol ozonizado de 300 mEq/kgO2, en jóvenes estudiantes de entre 21 a 23 años, como agente de neutralización en los cambios de pH. Se realizó un estudio comparativo longitudinal en 13 sujetos después de su cepillado dental; se tomaron dos muestras en saliva estimulada con el test estandarizado Saliva-Check BUFFER (GC®EUROPE). La medición basal de pH fue 7.66 ± 0.09, cifra por encima del rango normal; después de la aplicación del aceite de girasol ozonizado (O3MX®300IP) el pH fue de 7.27 ± 0.19, estableciéndose una variación de 0.28 ± 0.48, t = 8.04, p < 0.05 (0.000). Este estudio revela una caída significativa en el pH salival después de aplicar aceite de girasol ozonizado, lo que sugiere su potencial como buffer del pH salival. Se necesitan más investigaciones para explorar las implicaciones clínicas para el manejo de la salud oral (AU)

Saliva, primarily composed of 99% water and 1% organic and inorganic molecules, typically maintains a pH range of 6.0 to 7.5 but can be influenced by various factors. This study aimed to assess the variation in salivary pH following manual topical application of 300 mEq/kgO2 ozonated sunflower oil to the masticatory mucosa and dental structures in young individuals aged 21 to 23 years, using it as a pH-neutralizing agent. A longitudinal comparative study was conducted on 13 subjects after dental brushing. Stimulated saliva samples were collected using the standardized Saliva-Check BUFFER Test (GC®EUROPE). An initial baseline pH measurement of 7.66 ± 0.09 was obtained, which was above the normal range. Following the application of ozonated sunflower oil (O3MX®300IP), the pH dropped to 7.27 ± 0.19, indicating a variation of 0.28 ± 0.48 (t = 8.04, p < 0.05 (0.000). In conclusion, this study reveals a significant decrease in salivary pH after applying ozonated sunflower oil, suggesting its potential as a salivary pH buffer. Further research is needed to explore the clinical implications for oral health management.(AU)

Effectiveness of picture-based interventions of toothbrush training on improvement of oral hygiene in children with autism spectrum disorders: A systematic review and meta-analysis.

BACKGROUND: Children with autism exhibit a higher risk of poor oral health due to difficulty in the performance of simple tasks such as toothbrushing. AIM: This current systematic review aims to evaluate the effectiveness of Picture based intervention of toothbrush training on improvement of oral hygiene in children with autism spectrum disorders (ASD) MATERIALS AND METHODS: Prospero registered (CRD42023450156). PubMed, Cochrane, Scopus databases are searched from years January 1, 1980 to August 1, 2023 using broad search terms (brush) AND (autism). RESULTS: The search queries have identified 853 titles, from three databases (PubMed, Scopus, Cochrane), after application of filters for exclusion of systematic reviews and meta-analysis, duplicate exclusion and removal of irrelevant titles led to the final inclusion of 24 articles for full text screening. From the 24 included studies, 10 studies (four RCTs and six non-randomized clinical studies) sustained the final rigorous PICO search. Quantitative pooling of data were performed for limited articles. CONCLUSION: Low quality evidence suggest that picture-based intervention of toothbrush training has significant improvement (p ≤ .05) in improving toothbrushing habit as well as performance as indicated by the Plaque Index score (PI), Gingival index (GI) and Oral hygiene index score (OHI-S).

The influence of radio frequency-based toothbrush on the accumulation of calculus and periodontal health: A randomized double-blind controlled prospective study.

OBJECTIVES: The use of a toothbrush with radio frequency (RF) has shown to be of benefit regarding the reduction of plaque, calculus, and dental staining and improving teeth shade compared to conventional powered and manual toothbrushes. AIM: To evaluate the efficacy of the RF toothbrush in the reduction of calculus accumulation and its effect on periodontal parameters as well as subject satisfaction as compared to an identical sham-tooth brush. MATERIALS AND METHODS: Patients who are under a strict maintenance program were included. Patients were allocated to test (RF toothbrush) or control (sham) randomly and were examined at baseline, one and three months. Clinical photos were taken and a consequential calculus assessment via ImageJ software. Clinical assessment included the following: plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD), and recession (REC). Patient satisfaction was assessed via a questionnaire. RESULTS: Fifty-eight patients (29 control, 29 test) were included. At baseline mean PPD, BOP, PI, REC, and calculus accumulation were similar between the groups. Mean buccal calculus was lower in the test group at one month 4.0% versus 6.7%, p < .05. Calculus accumulation within the groups was lower in the test group at 1 and 3 months when compared to baseline at the buccal aspect (2.8% vs. 8.9%, p < .05% and 3.8% vs. 8.9%, p < .05) and lingual aspect (6.7% vs. 16.5%, p < .05% and 8.9% vs. 16.5%, p < .05). No statistically significant results were found regarding periodontal parameters PPD, BOP, PI, and REC. No difference was found between groups regarding patient satisfaction. CONCLUSION: RF seems to have an additive effect on preventing calculus accumulation on the buccal aspect of anterior mandibular teeth at 1 month. Nevertheless, at 3 months, no difference between the toothbrushes is seen regarding calculus formation and maintaining periodontal health (ClinicalTrials.gov, Identifier NCT04640857).

Bathroom Behaviors Regarding Oral Hygiene Items During COVID-19 Home Isolation: A Cross-Sectional Study in Southern Brazil

ABSTRACT Objective: To describe behaviors with oral hygiene items in single-bathroom households during the domiciliary isolation of individuals with positive 'Reverse transcriptase polymerase chain reaction' (RTPCR+) in southern Brazil. Material and Methods: Cross-sectional study was conducted with Research and Monitoring Sector of COVID-19 data from Palhoça, Brazil, of individuals aged ≥18 years, living in a singlebathroom household, who had an RT-PCR positive. A link of Google Forms was used. Socio-demographic information, characteristics during the home isolation, oral hygiene, and behaviors with oral hygiene items in the bathroom were collected. Descriptive stratified analyses according to age were conducted (<40 and ≥40 years). Results: Among 524 individuals, 36% were aged ≥40 years. During isolation, according to the behaviors with oral hygiene items in the household single-bathroom, 70% (95%CI 64.9-75.5) of the youngest participants reported sharing toothbrushes in the same container and 30% (95%CI 24.4-35.1) of the oldest; use of the same toothpaste was reported by 67% (95%CI 62.8-71.7) of the youngest and 33% (95%CI 28.337.3) of the oldest participants. For the outcome of sharing the same toothpaste, the chances for the youngest and the oldest to share the same toothbrush container was 11 times and 6 times more, respectively. Conclusion: The individuals related good oral hygiene habits; however, behaviors with oral hygiene items in the bathroom were neglected, especially by the younger individuals.

Clinical Efficacy of the Oral Health System by Fresh Health Inc. in Adults on Gingivitis and Plaque in a 3-Arm, 30-Day Study as Compared to String Floss and Manual Brushing.

OBJECTIVE: To evaluate the safety and efficacy of the Oral Health System by Fresh Health Inc., used in conjunction with manual toothbrushing (Fresh + MTB) as compared to string floss and manual toothbrushing (floss + MTB) and manual toothbrushing (MTB) alone, as measured by clinical signs of gingivitis, plaque reduction, pocket depth, and bleeding. METHODS: One hundred ninety-two (192) generally healthy adults exhibiting signs of gingivitis completed this 30-day randomized, controlled, examiner-blinded, three-group parallel study design. All subjects were assigned a manual toothbrush and fluoride dentifrice, instructed to brush twice daily according to their normal habits, and provided with written and verbal instructions for all assigned products. Subjects in the control group used only the manual toothbrush and dentifrice. Subjects assigned to the string floss + MTB group were instructed to also floss once daily. Subjects assigned to the Fresh + MTB group were provided a Fresh Health Inc. custom-fit oral irrigator and instructed to use the device once daily with water for approximately 7 seconds in addition to toothbrushing. Gingivitis was assessed using the modified gingival index (MGI), bleeding on marginal probing was assessed via the gingival bleeding index (GBI), and plaque was measured using the Rustogi modified navy plaque index (RMNPI) at day 1, day 15, and day 30. Periodontal probing depth (PPD) and bleeding on probing (BOP) were measured at day 1 and day 30. Oral soft- and hard-tissue assessments were performed at all examination visits. RESULTS: There was no significant difference in age or sex between groups, and no significant difference in baseline MGI, GBI, RMNPI, BOP, and PPD values across groups. The Fresh + MTB group demonstrated statistically significantly better performance than the floss + MTB group and MTB group across all clinical indices at both 15 days and 30 days. At 30 days, the Fresh + MTB group showed a 40.9% improvement in whole-mouth MGI, which was significantly greater than the MTB and floss + MTB groups.

Plaque removal by a novel prototype power toothbrush versus a manual toothbrush: A randomized, exploratory clinical study.

OBJECTIVES: This exploratory study investigated plaque removal with a prototype constant, low rotation speed Power Toothbrush (PTB) with two brushing actions: "Gumline" (head rotates in the horizontal axis) and "Interdental" (head rotates in the vertical axis). Gumline alone and "Combined" (Gumline + Interdental) modes were compared with a Reference PTB and a Reference Manual Toothbrush (MTB) after one brushing. MATERIALS AND METHODS: Thirty-nine participants were randomized to use each toothbrush once either in the sequence (A) Prototype PTB (in Gumline then Combined mode), (B) reference MTB, and (C) reference PTB or the sequence BAC. There was a minimum 3-day washout between the use of each toothbrush. Plaque removal was measured using the Rustogi Modified Navy Dental Plaque Index (RMNPI) with change from baseline investigated using an analysis of covariance model. RMNPI scores were calculated on a "whole mouth" basis and along the gingival margin and at proximal sites only. RESULTS: For the primary efficacy variable, a significant difference was found in favor of the prototype PTB in gumline mode versus the reference MTB for whole mouth plaque score (difference: -0.06; standard error: 0.014; 95% confidence interval [CI] -0.09 to -0.04; p < .0001). Similar significant differences were found in gingival margin and proximal areas (p < .0001). The prototype PTB in gumline mode removed significantly less plaque than the prototype PTB in combined mode and the reference PTB (p < .0001; whole mouth/gingival/proximal areas). The prototype PTB in combined mode removed significantly more plaque than the reference MTB (p < .0001; whole mouth/gingival/proximal areas) and the reference PTB for whole mouth (p = .0214) and gingival margin areas (p = .0010). The reference PTB also removed significantly more plaque than the reference MTB (p < .0001; whole mouth/gingival/proximal areas). All brushes were generally well-tolerated. CONCLUSION: The prototype PTB design, providing two distinct cleaning modalities, can effectively remove plaque to a significantly higher degree than an MTB and a marketed PTB, depending on mode.

Effect of the toothbrush tuft arrangement and bristle stiffness on the abrasive dentin wear.

The geometrical properties of toothbrushes play a role in developing abrasive tooth wear and non-carious cervical lesions. This study investigated the interplay between the toothbrush tuft arrangement (crossed vs. parallel) and bristle stiffness (soft vs. medium) on the abrasive dentin wear using three slurries with different levels of abrasivity (RDA: 67, 121 and 174). Twelve groups of bovine dentin samples (n = 20) were brushed with a combination of the aforementioned variables. Abrasive dentin wear was recorded with a profilometer and the resulting abrasive wear of each group was calculated and compared with each other using two-way ANOVA and pairwise tests. Toothbrushes with parallel tuft arrangement caused statistically significantly higher dentin wear compared to crossed tuft arrangement, regardless of the abrasivity level of the used slurry and the bristle stiffness. Soft crossed tuft toothbrushes caused statistically significantly higher abrasive dentin wear than medium crossed tuft toothbrushes, while soft and medium parallel tuft toothbrushes caused the same amounts of dentin wear, regardless of the RDA value of the used slurry. These results could be helpful for dentists and dental hygienists when advising patients. Crossed tuft toothbrushes could be a less-abrasive choice in comparison to parallel tuft toothbrushes.