Effectiveness of Different Bristle Designs of Toothbrushes and Periodontal Status among Fixed Orthodontic Patients: A Double-blind Crossover Design

Abstract

Aim:The aim of the present study was to evaluate the effectiveness of different bristle designs of toothbrushes and the periodontal status among patients undergoing fixed orthodontic treatment. Materials and methods:This randomized controlled trial (RCT) consisted of 45 adolescents (comprising 20 males and 25 females) undergoing fixed orthodontic treatment. The study participants were randomly allocated to three groups, each group being assigned a locally available toothbrush with a particular design of toothbrush bristle. In the first test phase, group I study participants were allocated to toothbrush with flat bristles, group II study subjects were allocated to toothbrush with zigzag bristles, and group III study participants were allocated to toothbrush with crisscross bristles. The study participants were recalled after 4 weeks to check the effectiveness of the allocated toothbrushes. A washout period of 1 week was maintained to ensure that there was no carryover effect of the different bristle designs. In the second test phase, each patient used the opposite toothbrush bristle design (group I: toothbrush with zigzag bristles, group II: toothbrush with crisscross bristles, and group III: toothbrush with flat bristles). Plaque scores were measured using Turesky-Gilmore-Glickman modification of Quigley-Hein plaque index (PI). Effectiveness of Different Results:In both phase 1 and 2 of this RCT, toothbrush with crisscross bristles exhibited maximum plaque reduction among the three different bristle design toothbrushes following 30 days (p = 0.312 ± 0.102 and 0.280 ± 0.110, respectively), which was statistically significant. Conclusion:It was concluded that all the three designs of toothbrushes were effective in removing plaque in patients with fixed orthodontic appliances. But among the three different toothbrushes, toothbrush with crisscross bristles showed the highest mean plaque reduction.Clinical significance: Plaque accumulation around the orthodontic brackets and gingival margins is quite common among the fixed orthodontic patients, who encounter difficulty in maintaining good oral hygiene. Specially designed toothbrushes are very essential for effective plaque removal among the patients undergoing fixed orthodontic treatment.

Clinical Evaluation of Toothbrushes for Elderly Patients: A Crossover Study

“…Numerous studies have used this design to compare toothbrush efficacy. 13 , 26 , 28 , 29 , 31 , 32 The design in the current crossover clinical trial was balanced for first-order carryover effects, and the participants had a 2-week washout period.…”

A Comparison of Manual Nylon Bristle Toothbrushes versus Thermoplastic Elastomer Toothbrushes in Terms of Cleaning Efficacy and the Biological Potential Role on Gingival Health

“…Personal and professional oral hygiene practices are the procedures directed at the removal of dental plaque. A toothbrush is one of the most commonly used adjuncts for maintaining oral hygiene [1]. The design of the modern conventional manual toothbrush can be attributed to Dr. Robert Hutson, a Californian periodontist, who, in the early 1950s, developed a multi-tufted, flat-trimmed, end-rounded nylon filament brush that became known as the OralB manual toothbrush [2].…”