The purpose of this study was to evaluate different methods of eliciting gingival bleeding as indicators of gingival inflammation in the experimental gingivitis model. Following a period of stringent oral hygiene, 103 dental students were scored for plaque and gingival bleeding assessed by 4 methods. From this group, 41 volunteers were randomly allocated to 2 treatment groups. Dental students with clean teeth and healthy gingivae were asked to abolish all mechanical tooth cleaning in the lower jaw for a period of 3-weeks. During the 21-day experimental period, chlorhexidine (Peridex) or a placebo mouthrinse was applied to the lower jaw. Subjects brushed the upper jaw with a standard toothpaste. In principal, 2 different methods were employed to provoke bleeding: (1) at the marginal gingival tissue by running a probe along the soft tissue wall at the orifice of the pocket, and (2) by probing to the "bottom" of the pocket. Variations in the methods were based on angulation (AngBI, ParBI) of the probe in relation to the tooth surface and to the probing force (PPBI.25N, PPBI.75N). 1 randomly selected quadrant in the lower jaw was scored using the AngBI. The opposing quadrant was scored with a randomly-allocated bleeding index, either ParBI, PPBI.25N or PPBI.75N. The results of this study confirm earlier findings that the angulation of the probe determines the number of sites with bleeding observed. It also indicates that bleeding as elicited by probing to the bottom of the pocket is a poor indicator of early gingivitis. It is recommended that gingivitis should be assessed by probing the marginal gingiva.

This was a 2-part study. The purpose of the 1st part was to examine the relationship between brushing force and plaque removal efficacy comparing a regular manual toothbrush (M) with an electric toothbrush the Braun/Oral-B Plak Control (B). The study consisted of a single oral prophylaxis followed by 5 experiments which differed solely in respect to toothbrushing force. At baseline (after 24-h plaque accumulation), the amount of dental plaque was evaluated and subsequently, the subject's mouth was brushed by a dental hygienist. Brushing was carried out in a random split-mouth order. Either the 1st and 3rd quadrants or the 2nd and 4th quadrants were brushed with 1 toothbrush and the 2 remaining quadrants with the other. The available time for the brushing procedure was 2 min. After brushing, the amount of remaining dental plaque was assessed. The force used in experiment 1 through 5 was 100, 150, 200, 250, 300 g, respectively. The results show that when brushing force is increased, more plaque is removed with either of the two brushes. Except for the high brushing force (300 g), the electric toothbrush removed more plaque than the manual brush. The purpose of the 2nd part was to evaluate the habitual brushing force which individuals use with various toothbrushes. Besides a manual toothbrush (M), 3 electric toothbrushes were examined, the Rotadent (R), Interplak (I) and Braun (B). 20 subjects were selected on the basis of being 'good brushers' (plaque score at screening < 25%). At baseline, each subject randomly received 1 of the 4 brushes. They were allowed a training period of 3 weeks at the end of which they were asked to abstain from brushing for at least 24 h. The plaque (Turesky modification of the Quigley & Hein) was scored, after which the subjects brushed their teeth (2 min) with the assigned toothbrush equipped with a strain gauge. A computer set-up measured (100 Hz) and calculated the mean brushing force. After brushing, the amount of remaining plaque was assessed. The design of the study was a 4-way cross-over. The results show that with a manual brush, considerably more force is used than with the electric brushes (R = 96, I = 119, B = 146, M = 273). No significant relation between brushing force and plaque removal was demonstrated for any of the brushes.

The purpose of this study was to evaluate the safety and efficacy of the Braun Plak Control for the removal of supragingival plaque and improving gingival health in a long-term clinical trial, and to compare it to regular manual toothbrush. Assessed were plaque accumulation, amount of gingival inflammation, gingival bleeding on probing, and calculus. In total, 77 young individuals were selected on the basis of having 'moderate gingivitis'. They were monitored over 8 months and divided among 2 groups; a control group that used a manual toothbrush and a test group that used the Braun Plak Control. The clinical assessments were repeated after 1, 2, 5, and 8 months. At baseline, subjects were handed their assigned toothbrushes together with written oral hygiene instructions. They were instructed to brush for at least 2 min. 1 month after baseline examinations, all subjects received a professional prophylaxis and oral hygiene instruction from an experienced dental hygienist. Plaque removal was reinforced at the 2-and 5-month examination. In conclusion, results indicate that the Braun Plak Control is a safe and efficient home care device. At the end of this trial, this electric toothbrush proved to be more effective than a regular manual toothbrush.

The purpose of the present study was to establish in vitro the inhibiting effect of a herbal extract mixture on a selected number of micro-organisms and to test in vivo the effect of a mouthwash containing 6.3 mg/ml herbal extract mixture on plaque and gingivitis as compared to a minus active control mouthrinse. The herbal extract was a mixture of: Juniperus communis (juniper), Urtica dioca (nettle), Achillaea millefolium (yarrow); 1:1:1. In the study, in-vitro, the effect of pure herbal extract mixture on acid production of Streptococcus mutans was tested and the minimum inhibitory concentrations (MIC) of the following micro-organisms were tested: Streptococcus mutans, Streptococcus mitis, Actynomyces viscosus, Actynomyces naeslundii, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Campylobacter rectus, Fusobacterium nucleatum, Veillonella parvula. The MIC-values for A. viscosus and P. gingivalis were 100 mg/ml. The MIC-values for A. naeslundii and A. actinomycetemcomitans were considerably lower (10 mg/ml). S. mitis was the most susceptible of the tested organisms to the extract with a MIC value of 1 mg/ml. S. mutans, C. rectus, V. parvula, and F. nucleatum were not influenced by the extracts. No inhibitory effect of the 6.3 mg/ml herbal extract mixture was observed on the acid production of S. mutans. For the study in-vivo, 45 volunteers were selected on the basis of having moderate gingival inflammation. As efficacy parameters the plaque index, modified gingival index and angulated bleeding index were assessed. The subjects were randomly divided among 3 experimental groups (2x test and 1 'minus active' control). The participants were requested to rinse with 10 ml of mouthwash twice a day for a period of three months. After 6 weeks and 3 months, the same clinical indices as at baseline were recorded. The results show no difference between the two test groups and the control group. In conclusion, the results of the present study have shown that the mixture of the 3 herbal extracts, Juniperus communis, Urtica dioca and Achillaea millefolium when used in a mouthrinse has no effect on plaque growth and gingival health.

The purpose of the present study was to compare the Braun/Oral-B Plak Control (D7) and Sonicare (S) in their plaque-removing efficacy. For this study, 35 university students (non-dental) were selected. This was a 2-part study. Prior to each appointment, all subjects were asked to abstain from all oral hygiene procedures for at least 24 h. In Part 1, the efficacy of the toothbrush was studied when one of the investigators brushed the teeth of the panellists. In Part 2, the efficacy of toothbrushing was studied after the students had received professional instruction. The available time for the brushing amounted to a total of 2 min per mouth. Dental plaque was evaluated by means of the Silness and Löe plaque index assessed at 6 sites per tooth. Results showed that both in Part 2 and Part 1 the D7 removed significantly more plaque than the S-electric toothbrush. The plaque reduction assessed according to Silness and Löe in Part 1 was for the D7, 1.28 and for the S, 1.12. In Part 2, the reductions were 0.90 and 0.80, respectively. The majority (n = 34) of subjects preferred the D7 over the S. In conclusion, the results of the present study show that the oscillating/rotating toothbrush (Braun/ Oral-B Plak Control) is more effective in plaque removal than the sonic electric toothbrush (Sonicare). In addition, given a choice, the panellists preferred the oscillating/rotating electric toothbrush.