Toothbrushing: to the best of one’s abilities is possibly not good enough

Deinzer, Renate; Ebel, S.; Blättermann, Helen; Weik, Ulrike; Margraf-Stiksrud, Jutta

doi:10.1186/s12903-018-0633-0

Cited by 35 publications

(72 citation statements)

References 16 publications

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“…The results of the present study thus support what has been found earlier [4–6, 8, 10]: Young adults appear to have problems to remove all plaque deposits even when they are brushing without any time limit and to the best of their abilities. The present study furthermore extends this result in showing that this problem is not confined to users of a manual toothbrush but exists to the same extent in daily users of a powered toothbrush.…”

Section: Discussionsupporting

confidence: 91%

“…Persons who habitually use a manual toothbrush appear to have difficulties to achieve oral cleanliness even when brushing to the best of their abilities [4–10]. Therefore, the present study aimed to assess whether daily users of a powered toothbrush would show results that are more favorable.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, one might criticize, that brushing to the best of one’s ability instead of brushing as ‘normal’ was investigated in this study. This, however, was exactly the aim of the study, as it is important to figure out what patients can achieve by applying maximum effort (for a comparison of “normal” brushing behavior to brushing to the best of one’s ability see [10]). Only on this basis, one can conclude whether hygiene deficits result from a lack of motivation or rather from a lack of skills.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, a recent series of studies has shown that dental laypeople (i.e. people without any dental background) hardly ever manage to clean more than 30–40% of their gingival margins by means of manual toothbrushing even when they perform to the best of their abilities [4–10]. On the other side, dental professionals achieve oral cleanliness at more than 90% of their gingival margins [11].…”

Section: Introductionmentioning

confidence: 99%

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Oral cleanliness in daily users of powered vs. manual toothbrushes – a cross-sectional study

et al. 2019

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Background Toothbrushing is a daily routine. Still, when adults are asked to manually perform oral hygiene to the best of their abilities, a considerable amount of plaque persists. Little is known about the performance of people who use a powered toothbrush. The present study thus analysed whether the capability to achieve oral cleanliness is better in people for whom powered toothbrushing is a daily routine. Methods University students, who either performed powered ( N = 55) or manual ( N = 60) toothbrushing for more than 6 months on a daily basis were asked to clean their teeth to the best of their abilities by their own device. Plaque was assessed prior to and immediately after brushing. Furthermore, gingival bleeding, recessions, periodontal pocket depths and dental status were assessed. Oral hygiene performance was video-taped and analyzed with respect to brushing duration, sites of brushing and application of interproximal cleaning devices. Results No differences between groups were found with respect to plaque before and after brushing, clinical parameters and overall brushing duration (all p > 0.05, all d < 0.156). After brushing, plaque persisted at approximately 40% of the sections adjacent to the gingival margin in both groups. Conclusions No advantage of daily powered toothbrushing as compared to daily manual toothbrushing was seen with respect to oral hygiene or clinical parameters. The capability to achieve oral cleanliness was low, irrespective of the type of toothbrush under consideration. Additional effort is thus needed to improve this capability. Electronic supplementary material The online version of this article (10.1186/s12903-019-0790-9) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Oral cleanliness in daily users of powered vs. manual toothbrushes – a cross-sectional study

et al. 2019

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“…Details of behavioral analysis are reported in related work (see Deinzer, Ebel, et al 2018). Briefly, the videos were analyzed with Mangold INTERACT 14 software.…”

Section: Observed Oral Hygiene Behaviormentioning

confidence: 99%

High Plaque Levels after Thorough Toothbrushing: What Impedes Efficacy?

Ebel

Weik

Margraf-Stiksrud

et al. 2018

JDR Clinical & Translational Research

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Objectives: Previous studies have shown high levels of dental plaque after toothbrushing and poor toothbrushing performance. There is a lack of evidence about what oral hygiene behavior predicts persistent plaque. The present cross-sectional study thus relates toothbrushing behavior to oral cleanliness after brushing and to gingivitis. Methods: All young adults from a central town in Germany who turned 18 y old in the year prior to the examination were invited to participate in the study. They were asked to clean their teeth to their best abilities while being filmed. Videos were analyzed regarding brushing movements (vertical, circular, horizontal, modified Bass technique) and evenness of distribution of brushing time across vestibular (labial/buccal) and palatinal (lingual/ palatinal) surfaces. Dental status, gingival bleeding, and oral cleanliness after oral hygiene were assessed. Results: Ninety-eight young adults participated in the study. Gingival margins showed persistent plaque at 69.48% ± 12.31% sites (mean ± SD) after participants brushed to their best abilities. Regression analyses with the brushing movements and evenness of distribution of brushing time as predictors explained 15.2% (adjusted R 2 = 0.152, P = 0.001) of the variance in marginal plaque and 19.4% (adjusted R 2 = 0.194, P < 0.001) of the variance in bleeding. Evenness of distribution of brushing time was the most important behavioral predictor. Conclusion: Even when asked to perform optimal oral hygiene, young German adults distributed their brushing time across surfaces unevenly. Compared with brushing movements, this factor turned out to be of more significance when explaining the variance of plaque and bleeding. Knowledge Transfer Statement: Results of this study can help clinicians and patients understand the meaning of specific behavioral aspects of toothbrushing for oral cleanliness and oral health.

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A randomized double‐blind clinical trial evaluating comparative plaque and gingival health associated with commercially available stannous fluoride‐containing dentifrices as compared to a sodium fluoride control dentifrice

Geisinger

Geurs

Nový

et al. 2023

Journal of Periodontology

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BackgroundGingivitis is a non‐specific inflammatory lesion in response to the accumulation of oral biofilm and is a necessary precursor to periodontitis. Enhanced oral hygiene practices, including utilization of a dentifrice that could significantly improve plaque accumulation and gingival inflammation, is desirable to prevent and treat gingivitis and potentially prevent progression to periodontitis. This clinical study aimed to investigate the effect of a new stannous fluoride‐containing dentifrice with 2.6% ethylenediamine tetra acetic acid (EDTA) as an anti‐tartar agent to reduce plaque index and gingival index over a 3‐month study period compared to other commercially‐available fluoride‐containing dentifrices.MethodsThis double‐blind, randomized controlled clinical study evaluated plaque, gingival inflammation, and sulcular bleeding in patients using one of five commercially available fluoride‐containing dentifrices The dentifrices tested contained: 0.454% stannous fluoride and 2.6% EDTA (D1), 0.24% sodium fluoride (C), and 0.454% stannous fluoride (D2‐D4). One hundred fifty subjects participated over a 3‐month period. Co‐primary endpoints were improvements in plaque index (PI) and modified gingival index (mGI) from baseline values. No professional cleaning was performed during the study period.ResultsAll subjects in the study demonstrated statistically significant improvements in all measures of oral hygiene over the 3‐month study period. Subjects using dentifrice 1 (D1) showed statistically significantly greater reductions in PI, mGI, and modified sulcular bleeding index (mSBI) compared with all other commercially‐available dentifrices tested (p < 0.00001).ConclusionsA new dentifrice with 0.454% stannous fluoride and 2.6% EDTA demonstrated significant improvements in clinical parameters associated with gingivitis compared to other sodium and stannous fluoride containing dentifrices.

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Toothbrushing: to the best of one’s abilities is possibly not good enough

Cited by 35 publications

References 16 publications

Oral cleanliness in daily users of powered vs. manual toothbrushes – a cross-sectional study

Oral cleanliness in daily users of powered vs. manual toothbrushes – a cross-sectional study

High Plaque Levels after Thorough Toothbrushing: What Impedes Efficacy?

A randomized double‐blind clinical trial evaluating comparative plaque and gingival health associated with commercially available stannous fluoride‐containing dentifrices as compared to a sodium fluoride control dentifrice

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