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Notes: Background: Toothbrush filament configuration now varies considerably, usually with the intention of improving plaque removal overall or from specific sites.Aims: The aim of the study was to compare 2 branded toothbrushes with a brush designed with a convex filament head arrangement to improve plaque removal from teeth with buccal gingival recession.Methods: The study was a randomised, 3-treatment, double-blind crossover design balanced for residual effects and involving 18 healthy volunteers. On day 1, subjects suspended toothcleaning and returned to the clinic on day 4. Plaque was scored by area and index before and after 2 min of toothbrushing with the allocated brush. Brushing was performed by a hygienist allocating a timed 15 s to each of the 8 buccal and lingual quadrants. 3 days was allowed between treatment periods.Results: Plaque accumulation differed considerably by site as did plaque removal. Overall plaque removal was 40%. Analysis showed significant subject differences but, no significant period or treatment differences.Conclusions: Consistent with other reports, it must be concluded that brush design is not a major variable in plaque removal. However using this “robot”-like model, the dentition of some individuals and specific dental surfaces are inherently more difficult to clean than others.

Notes: Background and aims: A limited amount of data using flat trim multitufted toothbrushes shows that abrasion of substrate surfaces by a standard toothpaste varies dependent on filament stiffness and configuration; soft brushes producing the most abrasion. The aims of these studies in vitro were to assess toothpaste abrasion of acrylic and stain removal by 5 proprietary medium toothbrushes with different head filament arrangements, and a prototype brush with rectangular filaments. The prototype brush had a medium texture in the long axis and soft texture at right angles to the long axis.Material and method: Optically clear acrylic was used as the substrate for abrasion by a standard toothpaste. Loss of substrate was determined by profilometry after 5000, 10 000, 15 000 and 20 000 linear or rotary brushing actions. Stain removal was determined spectrophotometrically from optically clear acrylic specimens stained by chlorhexidine tea soaking sequences. Stained specimens were brushed with water using linear or rotary actions and measurements taken every 10 s to 60 s.Results: Abrasion was progressive with increasing strokes and the pattern for each brush and brush action was to a first approximation linear. Overall, abrasion was significantly greater with linear compared to rotary action. Also overall brushes differed in the abrasion produced with both actions and particularly at greater exposure times. Within brush differences for the two motions were all significant by 20 000 strokes except for the prototype brush. Stain removal was progressive over time with each brush but the pattern was non-linear. For the proprietary brushes the rotary motion removed less stain. For the prototype brush more stain was removed with the rotary action. Overall brushes differed significantly in stain removal within each motion and for each motion most differences between the proprietary and prototype brushes reached significance.Conclusions: The differences between brushes for both abrasion and stain removal must in large part relate to the filament contact area with the substrate surface. Whilst the model may not be predictive of clinical differences, it could find use to establish minimum criteria for toothbrush action.

Notes: Background and aim: Considerable interest has been shown in the plaque removal properties of modern toothbrush designs. The primary aim of the study was to compare the plaque removal properties of 8 relatively recent designs of manual toothbrush using a professional tooth brusher and within a commonly used time frame. A secondary aim was established to utilise the data to observationally appraise plaque accumulation together with the patterns of removal as a consequence of using the timed professional tooth brusher.Method: The method was an 8-period, single-examiner, randomized, blind cross-over study involving 24 healthy volunteers, balanced for residual effects. Subjects accumulated plaque over a 4 day no oral hygiene period. On day 4, the accumulated plaque was scored by plaque index at the mesial, mid and distal sites of each of the buccal and lingual surfaces of the assessed teeth. Subjects were then removed from the assessment area where they received a professional brushing timed to last 48 s. Brushing was completed according to pre-study training without toothpaste and was followed by a re-scoring of the remaining plaque. A washout period of 3 days was then allowed prior to the next period during which normal oral hygiene was resumed.Results: Similar quantities of plaque accumulated in each arch, although the difference between the buccal and lingual surfaces was of the order of 30%. The professional toothbrusher removed approximately 40% of the accumulated plaque in the 48 s allocated. The buccal surfaces were most effectively cleaned (≈45%) compared with the lingual (≈25%), with the plaque removal in the mesial and mid sections approaching 40% and 60% respectively. The difference in performance between the test brushes corresponded to 5% of the residual plaque values with none being significantly more efficient overall. Pair wise site comparisons did produce differences of the order of 10% (p=0.004) at the mesio-buccal, and 8% (p=0.030) at the mid-buccal sites respectively in favour of 2 brushes compared to one other brush.Conclusions: These data derived from a standardized brushing method support the contention of many researchers that there is no one superior design of manual toothbrush. The minor and few site differences in favour of some brushes are unlikely to be of clinical significance to gingival health. This leaves uncontested the conclusion that the user is by far the most significant variable. Perhaps methods such as used in the present study could be more gainly employed to set a minimum standard of toothbrush efficacy.

Notes: Background: The consensus has been that there is no one superior design of manual toothbrush for plaque removal, despite, in some cases, encouraging findings from laboratory studies. The user appears the major variable and may mask differences in brush efficacy.Aims: The aim of this study was to compare 2 new double-filament texture brushes with 3 established brands for plaque removal, under standardised conditions of professional brushing.Method: The study was a blind, randomised crossover design, balanced for residual effects. A panel of 15 subjects suspended tooth cleaning for 3 days. On day 4, plaque was scored from 6 sites per tooth before and after a 2-min professional toothbrushing. A washout period of at least 3 days was allowed between study periods.Results: Overall plaque removal was 50% with no significant differences between brushes, a 3% absolute difference in average total mouth plaque separating brushes. However, at upper- and mid-buccal sites, a not significant 8% and a significant 9% difference, respectively, in plaque removal were recorded in favour of one of the prototype brushes, and at the mid-lingual site, there was a non-significant 10% difference in favour of one branded brush. Other sites were cleaned similarly by all brushes except for reduced plaque removal from buccal compared to lingual surfaces and interproximal compared to mid-surface sites. Highly significant subject differences in plaque removal were noted which may be relevant to inherent anatomical difficulties in tooth cleaning for some individuals. Period effects were not significant, supporting the consistency in brushing by the professional brusher.Conclusion: The method appeared capable of detecting small benefits of brush design. However, the benefits reported must be taken within the context of an overall lack of difference between brushes. The method could be used to set and record a minimum level of efficacy for toothbrushes.