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Abstract Background Oral health care behaviors during pregnancy affects maternal and child health outcomes. This scoping review sought to map the existing literature on the oral healthcare behaviors of pregnant women in Nigeria. Methods PubMed, Science Direct, Web of Science, EBSCOHOST, Sabinet, African Index Medicus, and Scopus data based were searched in August 2023. Articles with reports on the oral health behavior of pregnant women in Nigeria, published in English in peer review were included in the review. Articles whose full lengths could not be accessed, and commentaries on studies, and letters to the editor were also excluded. Data on authors and year of publication of the study, study location, study objective, study design, methodological approach for data collection, and study outcomes were extracted and descriptively synthesized. Results The search yielded a total of 595 articles of which 573 were unique. Only 21 articles were left after titles and abstracts screening and only 18 articles met the eligibility criteria. The proportion of pregnant women had utilized dental services ranged from 4 to 62.9%, the use of toothbrush and toothpaste ranged from 59.6 to 99.3%, twice daily tooth brushing ranged from 5.2 to 66.9%, and the use of toothbrush among pregnant women in the studies varies from 70.9 to 100%. Chewing stick was used by 0.1–27.7% of study participants. Dental problems such as caries, pain, swollen gums, and excessive salivation were reasons for seeking dental care. We identified individual, structural, and behavioral factors, including myths as barriers for dental service utilization. Conclusion This scoping review shows that dental service utilization by pregnant women in Nigeria is poor and mainly due to curative than preventive needs. Oral health behaviours also need to be improved through tailored oral health education accessible to pregnant women in Nigeria.

One of the most common children's dental health problems is dental caries. Childhood is the beginning of behavior formation, therefore it is hoped that parents can educate their children to behave correctly in maintaining healthy teeth and mouth.This research used descriptive survey research methods. The design of this research is cross sectional. The research was conducted at MIS Cempaka Putih and MIS Sungai Baru, South Kalimantan. The population in this study was all students in grades 4-6 at MIS Cempaka Putih and MIS Sungai Baru, there are 41 people. The sampling technique in this research used the total sampling method. The variables in this study are children's dental health behavior and the DMF-T index. The data that has been collected will be processed through editing, coding, tabulation and descriptive data analysis. This research was conducted at MIS Cempaka Putih and MIS Sungai Baru Banjarmasin in February 2022. Respondents were 10-12 years old. The dental health behavior of children in the good category was 14 people (34.15%), 15 people (36.58%), and 12 people less (29.27%). DMF-T index in the very high category was 3 people (7.32%), high was 4 people (9.76%), medium was 18 people (43.90%), low was 13 people (31.70%), and very low 3 people (7.32%). Based on the research results, it can be concluded that the dental health behavior of children in grades 4-6 at MIS Cempaka Putih and MIS Sungai Baru is mostly adequate for 15 people (36.58%). The class 4-6 DMF-T index in MIS Cempaka Putih and Sungai Baru has an average value of 3.5, including the medium category.

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 (

It is important for patients to understand that these conditions can be treated, but the success of treatment greatly depends on their level of oral hygiene. Selecting the appropriate toothbrush and mastering the correct brushing technique to effectively remove dental plaque while avoiding any potential damage to the gums. In addition to toothbrushes, there are other devices available for comprehensive dental cleaning, such as floss, interdental sticks, interdental brushes, and oral irrigators. Currently, self-care recommendations for dental implants are primarily based on existing knowledge regarding natural teeth cleaning. Patient education on oral hygiene is an important component of their overall treatment. Maintaining a regular oral hygiene routine is essential for taking care of our mouths, ensuring healthy teeth, and achieving fresh breath. In conclusion, biofilm disruption mechanical methods integrated is indispensable for comprehensive oral healthcare.

Saadaq Adan Hussein,1 Abdirahman Aden Hussein,2 Ahmed Mohamed Nur,3 Ayan Nor Ali,4 Yahye Garad Mohamed,4 Abdul Jalil Abdullahi Ali3 1Department of Tropical and Infectious Diseases, Benadir University, Mogadishu, Somalia; 2Department Public Health, Ministry of Livestock, Forestry & Range, Mogadishu, Somalia; 3Department of M&E Statistic, Benadir University, Mogadishu, Somalia; 4Department Radiology, Mogadishu Somali Türkiye Training and Research Hospital, Mogadishu, SomaliaCorrespondence: Saadaq Adan Hussein, Department of Tropical and Infectious Diseases, Benadir University, Bundada Street, Wabari District, Mogadishu, Somalia, Tel +252612223224, Email sadakadamh@gmail.comBackground: Oral health is crucial for overall well-being and systemic health and Humans are exposed to several bacteria after birth and will causes systemic illnesses like septicemia, respiratory, gastrointestinal, and renal issues. This study aimed to evaluate undergraduate students’ knowledge, attitudes, and practices regarding toothbrush contamination and disinfection.Methods: A descriptive cross-sectional study was carried out with undergraduates from seven selected universities, including public and private universities. A closed-ended questionnaire containing 24 items was distributed to A total of 490 undergraduate students.Results: The study showed that (28.6%, n=140) had knowledge about toothbrush cleaning and disinfection. A total of (350, n=71.4%) needed to gain knowledge about toothbrush cleaning and disinfection. Fifty-two percent of the students feel that bacteria are the primary mode of toothbrush contamination. Many of the students had different ways of disinfecting toothbrushes, including, boiling a small pot of normal water (51.4%, n=252), chemical agent (31.8%, n=156), ultraviolet sanitizer (0.2%, n=4), and microwave radiation (0.2%, n=1) does not know (16.1%, n=79). Most students (76.9%, n=377) felt that toothbrush disinfection was necessary.Conclusion: Fewer students have sufficient knowledge about toothbrush contamination and practice disinfection methods, whereas most students need to be made aware of the contamination of toothbrushes and the use of disinfectant methods.Keywords: knowledge, practice, toothbrush, infection, contamination

Introduction: Gingival, periodontal diseases and dental caries are the most prevalent diseases of the oral cavity. Plaque is the main cause of these dental diseases. Plaque control is of prime importance for the maintenance of oral and dental health. The toothbrush is used very commonly for plaque control. A variety of toothbrushes are available, which are used for plaque removal. Toothbrushes cause abrasion and are significant in the development of tooth wear. This study aimed to compare the abrasion caused by a commercially available nylon bristle toothbrush to a biobased carbon-based bristle toothbrush. Materials and Methods: Acrylic plates were used to assess the abrasion caused by the nylon bristles and biobased carbon bristles. The surface roughness (Ra) was evaluated on a device, and the values were compared to each other. Results: Brushing with the biobased carbon bristle toothbrush was less abrasive than when nylon bristles were used. The nylon bristles showed a higher Ra value as compared to biobased carbon bristles. Conclusion: The biobased carbon bristles are less abrasive, but studies are required to compare the plaque removal capacity of such biobased carbon bristle toothbrushes.

Key Clinical Message This report describes a case of an electric toothbrush head being retained between the floor of the mouth and the submandibular gland following a fall. Computed tomography imaging is recommended in cases of oral cavity damage to assess tissue damage and ascertain the position of the foreign body concerning blood vessels.

Abstract Objectives For people, it is challenging to be conscious of the appropriate toothbrushing time to maintain good oral health in daily life. The aim of this study was to preliminarily examine the utility of an application (app) that combines a toothbrushing timer and information on toothbrushes. Materials and Methods We developed the “Toothbrushing Timer with Information on Toothbrushes” app to help users ensure appropriate toothbrushing time and learn about the beneficial characteristics of toothbrushes. A total of 18 participants were registered for the study. At baseline (T0) and after 1 month (T1) of app usage, study participants answered a digital questionnaire that comprised three questions on oral health practice, self‐efficacy in oral hygiene, and quality of life related to oral health (Oral Health Impact Profile‐14 [OHIP‐14]). Results Five participants were excluded from the analysis as they did not answer the digital questionnaire. Finally, 13 participants completed the survey with a follow‐up of 1 month. The 13 participants were grouped into health professionals (n = 8) and non‐health professionals (n = 5). The total scores for oral health practice and self‐efficacy related to oral hygiene increased after a month of app usage in health professional and non‐health professional groups. However, there were no significant differences between T0 and T1 in either group. The total score of OHIP‐14 was lower at T1 than at T0 in both groups. Therefore, participants showed better oral health practice, self‐efficacy in oral hygiene, and quality of life related to oral health at T1 compared with that at T0. Conclusions Our app showed positive results for the users and is useful in maintaining and promoting oral health awareness and practice. However, our pilot study lacks sufficient power and did not yield significant differences. Therefore, high‐quality clinical trials with larger sample sizes are warranted for further improvement and evaluation.

Abstract 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

This study aims to investigate whether toothbrushes with fluoride-infused bristles have any (re)mineralisation effects on bovine enamel. Bovine incisors (N = 160) were extracted, and the buccal side of the crown was cut into dimensions of ~5 mm × 5 mm with a low-speed saw. These specimens were randomly allocated into four groups: half (80 teeth) were stored in demineralising solution (DM), and the other half were stored in deionised water (DW) for 96 h. Then, they were brushed with a force of 2.0 ± 0.1 N for five min with a manual toothbrush with either fluoride-infused (TF) or regular (TR) bristles. Microhardness (Vickers), X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy (EDS), and scanning electron microscopy (SEM) were used to investigate the surfaces of the bovine enamel specimens before and after brushing. Two-way ANOVA was used to analyse the hardness data, and the pairwise comparison method was used to analyse the Ca/P ratio, for each group at α = 0.05. The results show that brushing with either of these toothbrushes increased the Vickers microhardness on DM and DW enamel (p < 0.001), whereas hydroxyapatite was revealed in all groups by XRD. The DM samples showed a significant increase (p < 0.05) in the Ca/P ratios after brushing with TR and TF. Conversely, under DW conditions, these ratios decreased significantly after brushing. In terms of the F atomic%, TF increased significantly. SEM revealed mineral deposition in the DM groups after toothbrushing. To conclude, toothbrushing effectively induces the microhardness of sound and demineralised enamel, while fluoride-infused bristles might be able to retain fluoride on the enamel surface.

Abstract Objective Considering the rising prevalence of metabolic syndrome (MetS), this study aimed to investigate the relationship between MetS and its components with oral and dental health in the adult population of the Azar cohort. Methods In this cross-sectional study oral health care behaviors, DMFT (decayed, missing, and filled teeth) index, and demographic data related to 15,006 patients (5112 in the MetS group and 9894 in the healthy group) of the Azar Cohort population aging from 35 to 70 were collected using appropriate questionnaires. The definition of MetS was based on the National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria. Then, the risk factors of MetS related to oral health behaviors were determined by proper statistical analysis. Results The majority of MetS patients were female (66%) and uneducated (23%) (P

Abstract Objective This study aims to evaluate three types of manual toothbrushes [Cross action (CA), Flat trim (FT), and orthodontic type (OT)] in terms of efficacy in plaque removal in patients undergoing fixed orthodontic treatment. Background Manual toothbrushes are an essential part of oral hygiene for primary prevention. Plaque control, however, can be influenced by a number of individual and material-related factors. Individual factors include the presence of fixed orthodontic appliances on tooth surfaces, such as brackets and bands, which create difficulties with oral hygiene and lead to plaque formation. The evidence for the effectiveness of advanced bristle designs (multilevel, criss-cross) of the manual toothbrush alone in removing plaque in patients undergoing orthodontic therapy is limited. Methods The experiment followed the Consolidated Standards of Reporting Trials (CONSORT) guidelines. This was a three treatment, three-period crossover clinical trial with a single brushing exercise. Thirty subjects were randomized to one of the three treatment sequences of different bristle designs: (CA, FT, and OT). The primary outcome measure was the difference in the plaque scores (baseline minus post-brushing) at each study period, as determined by the Turesky-Modified Quigley–Hein Plaque Index. Results Of the thirty-four subjects enrolled in the study, thirty of the subjects met the inclusion criteria and completed all three periods of the study. The mean age was 19.5 ± 1.52 years, with a range of 18–23 years. The differences between treatments in plaque score reduction after brushing were statistically significant (p-value

Abstract Background Penetrating injury of the oropharynx occurs frequently in children, however, anesthetic management is seldom described in such cases. Case presentation A 2-year old child came to the emergency room with a toothbrush impacted in the gingivobuccal sulcus making airway management difficult. We used a simple yet unique approach to secure the airway safely given the lack of pediatric size fibreoptic and videolaryngoscopes in our emergency operation theatre. The patient was kept in Pediatric ICU and watched for any complications and discharged on the 4th postoperative day. Conclusions Thus, ingenious non-invasive techniques to secure the airway can prevent the patient from undergoing surgical tracheostomy.

Objective:This study evaluated the effect of translucency on the color stability of resin-based composites (RBCs).Methods:Different translucent/opaque shades of RBCs were used: Filtek Ultimate (FU); A2 Enamel, A2 Dentin, A2 Body, IPS Empres Direct (IED); A2 Enamel, A2 Dentin, GC Essentia (GC); LE, MD, Estelite Ʃ Quick (EQ); OA2, A2, CeramX duoSphertec and One (CX); E2, D2, A2. Disc-shaped specimens were stained in coffe and then brushed. The color changes (ΔE) were calculated between baseline and treatment. One-way ANOVA and Tukey’s post-hoc test were used for statistical analysis (α=0.05).Results:After staining, the difference between the ΔE values of RBCs was not statistically significant, except GC LE. After both staining and brushing, the ΔE values of the enamel shades were the highest, and the order of ΔE values was body > dentin for ESQ and CX, dentin > body for FU.Conclusion:The ΔE values of the enamel shades were the highest after both staining and brushing.

ABSTRACT: Objectives: The aim of this study was to evaluate the efficacy of 2 newly designed toothbrushes used by elderly individuals based on plaque removal and gingival inflammation reduction compared with 2 commercially available toothbrushes. Materials and methods: This was a randomised, controlled, single-blind, 4-period crossover clinical trial. Thirty elderly participants meeting the inclusion criteria were randomly allocated into 4 groups, which determined the sequence of the 4 toothbrushes: CUdent/extra soft, CUdent/soft, GoodAge, and Colgate. The participants’ baseline bleeding on probing (BOP) and plaque index (PI) were assessed by one blinded calibrated examiner, then their teeth were professionally cleaned. The participants were assigned to use the tested toothbrush and were recalled for postbrushing examination 2 weeks later to evaluate their BOP and PI. At the end of each test period, the participants used their own toothbrush during the 2-week washout period before using the next tested toothbrush. Results: The mean age of the 30 participants was 63.2 years. The mean baseline BOP score was 44.4%, and mean baseline PI was 2.7. Three participants dropped out; thus, 27 participants (15 females and 12 males) provided data throughout the study period. The participant characteristics and baseline data between the groups were similar. CUdent/extra soft and CUdent/soft demonstrated significantly better PI scores at the buccal surfaces than GoodAge (P < .05). CUdent/soft had the lowest PI scores and Colgate presented the lowest BOP score in every comparison for other areas; however, the differences were not significant. No signs of tissue trauma or abrasion were observed. Conclusions: The newly designed toothbrushes were comparable to the commercially available toothbrushes in plaque removal efficacy and reducing gingival inflammation. CUdent/extra soft and soft were significantly more effective in plaque removal in the buccal regions than GoodAge.

Aim: Chewable toothbrushes were compared to traditional manual toothbrushes in terms of their ability to remove plaque and their impact on salivary pH in a sample of school-aged children. Materials and Methods: The sample size for this research was 200 youngsters aged 10–12. Saliva was collected by spitting into a clean container, and the pH levels were measured using color-coded pH strips to determine where the person was starting from. The plaque score was measured using the OHI-S index after the application of the disclosing agent. The pH and plaque scores were also recalculated after brushing to see how they had changed after surgery. Results: Results indicated that both manual and chewable brushes significantly improved post-brushing pH ratings (P = 0.001), and that plaque scores decreased (P = 0.001). When compared to conventional manual toothbrushes, the chewable brush was much more successful in reducing plaque and elevating salivary pH (P = 0.001). Conclusion: As a result, parents may offer their kids a chewable toothbrush to help them maintain good oral hygiene after lunch and on lengthy car trips, when they would not have time to wash their teeth properly.

Introduction: The novel coronavirus disease has brought to the forefront the importance of oral hygiene aids and its role in the prevention of COVID-19 transmission. Objectives: The objective is to assess knowledge, attitude, and practice of oral hygiene aids and its role in COVID-19 transmission. Materials and Methods: This was a cross-sectional study conducted on 385 patients visiting Vishnu dental college. The questionnaire included demographic data, history of COVID, and vaccination status. The second part included questions regarding knowledge, attitude, and practice of oral hygiene aids and its role in COVID-19 transmission. Results: Mean age of the population was 40.11 years, and had almost equal proportions of males and females. About 22.6% of the population had suffered from COVID-19 and 92.7% of men got fully vaccinated. Knowledge of COVID-19 transmission through oral hygiene aids was found in 57.4% of the population. No difference in knowledge of occupational health advisor (OHA) and its role in COVID transmission was found between gender, COVID, and vaccination status (P > 0.05). About 22.9% of graduates had higher knowledge than others (P = 0.00). Conclusions: The use of appropriate oral hygiene aids and practices could prevent the transmission of COVID-19.

Abstract Background Maintaining good oral hygiene is key to preventing dental caries and periodontal disease. Children and adolescents with good oral hygiene behaviours are likely to grow into adults with the same behaviours. This study assessed the frequency of using various oral hygiene methods among children and adolescents from different countries and individual, familial and country-level factors associated with the use of these methods. Methods A multi-country online survey collected data from caregivers of children in 2020–21 about children’s use of oral hygiene methods including toothbrush, fluoridated toothpaste, mouthwash, dental floss and miswak using self-administered, close-ended questions. Adjusted multilevel logistic regression models were used to assess the relationship between each of the five oral hygiene methods (dependent variables) and the independent factors: sex, age, and history of dental visits (individual factors), mother's education and area of residence (familial factors) as well as country income and region (country-level factors). Results A total of 4766 parents/caregivers were included from 20 countries (77.4% Eastern Mediterranean-region and 41.6% lower middle income countries). The most frequent oral hygiene methods were using toothbrush and toothpaste (90% and 60.3%). The use of oral hygiene methods differed by age, sex and history of dental visits as well as mother’s education and area of residence (P

Introduction: Although different methods have been recommended for cleaning orthodontic retainers, a standard method has not yet been introduced. The present study aimed at evaluating the antibacterial effect of three different methods in cleaning Hawley and Essix retainers.Materials and Methods: A total of 30 patients with orthodontic appliances who were candidates for receiving orthodontic retainers after their treatment were divided into two groups, including Hawley and Essix (n=15 each). Each patient used three home disinfection protocols for cleaning the retainers. Protocol 1: the patients were instructed to clean their retainer using their received toothbrush and toothpaste 3 times a day. Protocol 2: the patients cleaned their retainers the same as in protocol 1. In addition, they were instructed to spray the retainer with 0.12% chlorhexidine for 30 min every night. Protocol 3: the patients were instructed to soak their retainer in distilled white vinegar (50%) for 15 min every night and then clean their retainer in the same way as in protocol 1. Each protocol was applied for 2 weeks, and there was a 2-week wash-out interval between the protocols. At the end of each protocol, samples were taken from each retainer and the number of Streptococcus mutans colonies was counted and compared between the groups. Kruskal-Wallis and Mann-Whitney tests were used for statistical analysis (P≤0.05).Results: Antibacterial effectiveness of the three cleaning protocols did not show a significant difference in the Essix and Hawley groups (P=0.510 and P=0.095, respectively). However, a significant difference between the two types of retainers was observed when the patients used protocol 2 for cleaning the retainers.Conclusion: Spraying chlorhexidine or soaking in vinegar following brushing of the retainers was equally effective as brushing the retainers with toothpaste alone.

Abstract Background Foreign body ingestion is a common case in daily medical care, and it usually passes through the entire gastrointestinal tract naturally and is excreted in the feces. However, long and sharp foreign bodies may be difficult to pass naturally due to their shape. Here, we present a rare case of a duodenal foreign body, a toothbrush, that required laparoscopic surgical removal after a failed endoscopic attempt. Case presentation A 51-year-old male with intellectual disability presented to our hospital due to fever. Initially, he was diagnosed with aspiration pneumonia by chest X-ray and blood examination. However, abdominal X-ray examination suggested a foreign body, and a computed tomography scan revealed a toothbrush in the duodenum. Therefore, upper gastrointestinal endoscopy was immediately attempted to remove it, but it could not be safely removed because the handle part of the toothbrush seemed deeply embedded in the duodenal mucosa. Therefore, this case was diagnosed as duodenal incarceration of the toothbrush, and it was removed by laparoscopic surgery. The operation was performed safely, and the patient’s postoperative course was good without any complications. The extracted toothbrush was 15 cm in length. Conclusion We experienced a rare case of a duodenal foreign body, which was a toothbrush. The duodenal foreign body was safely removed by laparoscopic surgery for the first time.

The development of simple sensing platforms for evaluating the oral conditions has attracted great attentions for healthcare. Saliva or toothpaste contains various analytes that can indicate health conditions. A salivary glucose sensing platform can provide a convenient and non-invasive alternative detection approach for diabetic patients. Toothbrush is used every day, and it has an easy access to saliva biomarker and toothpaste residues. Here, we demonstrate for the first time an amperometric biosensor on a toothbrush, using glucose as a typical analyte. The carbon graphite ink and the Ag/AgCl ink are painted on a toothbrush as the sensing electrodes, followed by the enzyme immobilization. The sensor shows an excellent detection performance for glucose with a concentration ranging from 0.18 mM to 5.22 mM and a short detection time of less than 5 min. The sensor is promising for the non-invasive monitoring of salivary glucose levels in diabetic patients when they brush their teeth. We anticipate that these results would open up exciting opportunities for developing new toothbrush sensors, as well as advance related healthcare applications.

Effective oral care is a critical requirement to maintain a high quality of life. Most oral diseases are caused by plaque (oral biofilm), which is also correlated with systemic diseases. A common method to remove biofilm is brushing teeth with toothpaste. However, 3.5 billion people in the world have oral diseases, meaning that more efficient methods of removing biofilms are needed. We have developed a toothbrush that applies a bioelectric effect (BE) utilizing an electric force for biofilm removal. It demonstrated significantly higher biofilm removal efficiency than non-BE manual toothbrushes. Tests were performed in saline and toothpaste conditions using various pressures. Results showed that the BE toothbrush had a significantly higher biofilm removal efficiency in saline (0.5 N: 215.43 ± 89.92%, 2.5 N: 116.77 ± 47.02%) and in a toothpaste slurry (0.5 N: 104.96 ± 98.93%, 2.5 N: 96.23 ± 35.16%) than non-BE manual toothbrushes. Results also showed that BE toothbrushes were less dependent on toothpaste. This study suggests that the application of BE can be a new solution to plaque problems in oral care.

Abstract Background To evaluate an experimental T-shaped toothbrush for plaque removal and gingival health when compared to a conventional toothbrush among children. Methods This single blind parallel randomized controlled trial was conducted on 8–10-year-old healthy schoolchildren with no history of recent antibiotic intake, proximal caries or more than 3 missing teeth per quadrant. A computer-generated randomization list allocated child to the 2 groups. Each child received detailed instructions for tooth brushing. Gingival health and plaque scores were recorded in school at baseline, 2 weeks, 1 month and 3 months in a portable dental chair by an examiner who was blind to the allocated toothbrush. A general feedback on the use of the T-shaped toothbrush was obtained at 3 months. Data was analyzed using two-way repeated measure ANOVA, Generalized estimating equation and Bonferroni test. Results A total of 195 eligible children were invited, 110 parents gave consent and 100 children completed the study; 50 in each group. There were statistically significant reductions in mean gingival and plaque scores at each visit when compared to baseline for both toothbrushes (p 0.05). Majority of participants gave positive feedback regarding the T-shaped toothbrush. Conclusions Both toothbrushes had similar efficacy in removing plaque and improving gingival health among children. The T-shaped toothbrush is an alternative to the conventional toothbrush for oral hygiene in children. Trial registration Retrospectively registered at ClinicalTrials.gov Registry—NCT03989479 18/06/2019.

PurposeDigital imaging technology and a real-time fluorescent quantitative polymerase chain reaction (RQ-PCR) were used to determine the changes in dental plaque caused by different toothbrushing tools.MethodsA total of 120 subjects were selected and divided into four groups: a manual toothbrush group, a manual toothbrush combined with an oral irrigator group, an electric toothbrush combined with an oral irrigator group, and an electric toothbrush group. We compared the changes in plaque count, plaque area, and colony colonization of the four groups after different cleaning tools had been used for a period of time.ResultsDental plaque count and plaque area decreased in all four groups. The decreases in plaque count and Streptococcus mutans in the electric toothbrush combined with an oral irrigator group were significantly higher than those in other groups.ConclusionElectric toothbrush combined with an oral irrigator shows a good result for plaque removal effect. Digital image analysis combined with biological methods can be used to evaluate dental plaque.

Background: Toothbrush is essential for removing dental biofilm and preventing dental caries and periodontal disease. Toothbrushes become contaminated after repeated use, so disinfection is necessary for tooth brush maintenance. It is critical that dentists should have a current understanding and perception of toothbrush contamination and disinfection. Objective: The aim of this study is to assess the knowledge, attitude, and practice among the dental interns, house staff, postgraduates, and faculty of the dental colleges in Kolkata city regarding toothbrush maintenance and disinfection. Materials and Methods: A cross-sectional questionnaire study was conducted among interns, house staff, postgraduates, and faculty of dental colleges in Kolkata, West Bengal, India. The data on oral health knowledge attitude practice (KAP) were collected using a self-structured questionnaire. Descriptive statistical analysis was evaluated in the form of frequencies and percentages. Results: A total of 138 participants responded to the survey. Knowledge regarding toothbrush disinfection was found to be in 84% of the participants with maximum in house staff with 75%. Majority of the participants will prefer chlorhexidine as solution of disinfecting the toothbrush. Ninety-seven percent of the participants think that the toothbrush disinfection is necessary for everybody. Conclusion: The majority of interns surveyed had no idea how to keep their toothbrushes clean. Despite being aware of the issue, some participants did not disinfect their toothbrushes. Education on how to use and maintain a toothbrush effectively would help to improve the KAP for toothbrush maintenance and disinfection.

Background and Objectives: The usage of a toothbrush with the most appropriate bristle type and a correct brushing technique are the most important factors in determining the thoroughness of plaque control. The dental undergraduate course conventionally does not impart tooth brushing techniques in the preclinical years. This study aimed to assess the effect of an educational intervention of correct tooth brushing technique on the wear of toothbrush bristles by light microscopic examination amongst the budding dental professionals. Materials and Methods: Toothbrush bristle wear was measured by light microscopy before and after an educational intervention amongst 30 first-year dental professional students. Wear index (WI), wear rate (WR), and acceptable percentage of bristle end morphology were calculated. Mann–Whitney U-statistics test and unpaired t-test were used to compare measurements of acceptable percentage and gender wise, respectively. The difference was said to be significant if P < 0.05. Results: The mean WI before intervention was 0.29 ± 0.122 and after the intervention was 0.23 ± 0.07, while the mean WR before intervention was 1.6 ± 0.167 and after the intervention was 1.17 ± 0.46% of bristle end morphology before intervention was 52.5 ± 10.064 and after intervention was 64.5 ± 5.625 with the difference being statistically significant with P < 0.05. Interpretations and Conclusion: The present study highlights the importance of imparting a correct tooth brushing technique in reducing the toothbrush bristle wear and improving the efficiency of the toothbrush in maintaining optimum oral hygiene. Early intervention of correct oral hygiene measures is especially prudent for the budding dental professional for future healthcare delivery to the general population.

Introduction: Resources for oral health care remain limited in in rural and backward areas where an inherent need to exists to explore inexpensive cleaning aids at ease. Aim: To assess the efficiency of Miswak stick as an oral hygiene aid among madrasa-going 12–14 years old children, by comparing it with toothbrush and toothpaste in Nuh district of Haryana, India. Materials and Methods: The study population comprised of 540 madrasa-going children. 400 cases were Miswak users, whereas 140 toothbrush and toothpaste users were in the control group. Their oral hygiene status was assessed using the Gingival Index (GI), Oral hygiene index- simplified (OHI-S) and Plaque Index (PI). Decayed, Missing, Filled Teeth (DMFT) index was used to measure the dental caries incidence. The data were recorded, tabulated, and statistically analyzed. Results and Discussion: The results showed that Miswak users had significantly less mean GI score and OHI-S index scores (P = 0.001) but no statistically significant difference in PI score as compared to toothbrush and toothpaste users. Second, DMFT score was more in toothbrush and toothpaste users as compared to Miswak users. Conclusion: This study concluded that the oral hygiene status of Miswak users in the madrasa-going children of Nuh district was better than that of toothbrush and toothpaste users.

Background: Toothbrush often gets contaminated with use and also during storage. Although many toothbrush disinfection methods are mentioned in the past literature. To date there no absolute consensus on the topic. Aims: This study aimed to evaluate the microbial contamination of toothbrushes and their decontamination using various disinfectants. Subjects and Methods: An in vitro study was carried out on 80 subjects with a gingival index (Loe and Silness, 1963) score of two or three received toothbrush and paste with complete oral hygiene instructions. After 1 month, toothbrushes were collected and checked for microbial contamination by aerobic culture. Toothbrushes were divided into four groups (n = 20) and treated with one of the following agents: Group A – 0.2% chlorhexidine gluconate, Group B – Listerine, Group C – Dettol, and Group D – tap water for 1 h. After an hour, the brushes were further cultured to evaluate the efficacy of each agent. Statistical procedures were performed using Statistical Package for the Social Sciences (SPSS) 16 software. Inferential statistics were performed using Chi-square analysis. P < 0.05 was set as statistically significant. Results: All the sampled toothbrushes had significant (P < 0.001) bacterial growth after 1 month of use. Most of the brushes were contaminated with Escherichia coli (17.1%). All the tested disinfectants significantly (P < 0.001) reduced bacterial growth and Dettol showed maximum effectiveness (95.3%). Conclusions: Toothbrushes significantly get contaminated after use, which is reduced after disinfecting the brushes. Although not 100% effective, all the disinfectants significantly reduced the bacteria, and Dettol was found to be comparatively better than other agents.

This retrospective study was designed to investigate the effectiveness of using a toothbrush, which is commonly used in our daily life, for biofilm removal and infection control in the treatment of spinal infections occurring after spinal fusion surgery. Currently, a biofilm is thought to form on the surface of the metal inserted during spine fusion surgery. We aim to determine the differences in clinical outcomes between using and not using a toothbrush to remove biofilm while performing conventional drainage, curettage, and debridement. A total of 1081 patients who underwent anterior or posterior spinal fusion surgery between November 2018 and October 2022 were screened. The study included 60 patients who developed surgical site infection and underwent incision and drainage surgery either with a toothbrush (n = 20) or without a toothbrush (n = 40). Failure of infection control that requires revision surgery occurred in 2 patients (10%) in the Toothbrush group and in 14 patients (35%) in the No-Toothbrush group (p = 0.039). Thus, the rate of additional surgery was significantly lower in the Toothbrush group. Additionally, normalization of c-reactive protein levels occurred significantly faster in the Toothbrush group (p = 0.044). Therefore, using a toothbrush to treat spinal infections following spinal fusion surgery appears to have beneficial mechanical debridement effects, resulting in improved clinical results, which were also confirmed based on the electron microscopic images.

Currently, an extensive variety of toothpastes are available on the market, containing basic components that are ubiquitous in all toothpastes, in addition to unique constituents that bestow characteristic traits, and it is crucial to acknowledge that certain components found in toothpastes are not recommended for ingestion due to their potentially negative impact on overall wellbeing, especially in children. This study aims to highlight the role of natural components as a substitute for toothpaste in achieving good oral hygiene and to focus on natural compounds that do not injure the body, especially considering the current trend towards the use of natural substances. Thus, the objective of this paper is to emphasize the advantages of using organic products. In Romania, due to the socio-economic conditions in rural areas, the use of these ingredients, which are available to everyone, could lead to an improvement in oral health. The study shows that a majority of 63% of the participants who used a toothpaste composed of natural constituents achieved an ISL bacterial plaque index equivalent of zero. This is noteworthy as the presence of the plaque index was detected in a mere minority of 13% of the subjects at the commencement of the study. To evaluate the effectiveness of the mentioned compounds in plaque removal, all participants in the study were instructed to use the same brushing technique known as the Bass method, which is recognized as one of the most effective techniques. The study concludes that mastery and application of the correct brushing technique, combined with toothpaste obtained from natural compounds, is successful in removing plaque.

One of the most discussed topics in toothbrush design is identifying the contact force exerted by the bristles on the teeth. Each bristle must generate a contact force to ensure tooth cleaning without damaging it. Numerical simulation is a very powerful tool for understanding the influence of design parameters (bristle shape and materials). This paper proposes a flexible multibody model to efficiently simulate the 3D compliance of a toothbrush. Each bristle is modeled using a discrete, flexible approach. The contact between the bristles and the target surface is established using the penalty contact method. An experimental test bench with a Universal Robot and a flat, transparent surface is set up. Validation is provided by comparing the reaction forces of the toothbrush with the reaction forces acquired by the load cells mounted on the end effector of the Robot. The results demonstrate the accuracy of estimating normal and tangential forces in various operating situations. The discrete flexible multibody technique has also demonstrated its viability in evaluating the displacement of the bristles when the toothbrush’s base body is put through a specified motion, even when it is exposed to a sudden change in direction. As a result, the model can be effectively utilized to assess how well various brush classes remove dental plaque. Therefore, the suggested model could provide guidance for holistic modeling and advancements in toothbrush design to boost their effectiveness for thorough cleaning.

Abstract Objectives To evaluate the effect of a novel radiofrequency (RF)‐utilizing toothbrush on reduction of stains and improvement of teeth shade. Materials and Methods This was an open label, prospective study, including six clinical visits that were conducted over a period of 8 weeks. Subjects performed twice daily brushing using a novel RF‐utilizing toothbrush, used manually with no mechanical vibration. Teeth shade and stains were assessed using Vita Easyshade advanced 4.0 device and a visual assessment of standardized digital photographs, before, and following 4 and 8 weeks of treatment. Results Twelve subjects completed the study with fully evaluable data. A notable shade improvement (whitening) was observed between the visits according to the average scores of teeth whitening index per subject. Statistical analysis conducted by the unstructured mix model confirmed a significant reduction in the average score of whitening index between baseline and visit 5 (p

Oral hygiene is a dental procedure with the role of removing bacterial plaque and action to prevent oral diseases, including periodontal disease. Oral prophylaxis includes both daily dental hygiene (daily brushing, flossing and mouthwash) and the visits to the dentist for professional hygiene and prophylaxis. The correct brushing of the teeth is important not only for maintaining oral health but also for the health of the whole body, because there are correlations between diseases of the oral cavity and problems of the digestive tract or even heart disease.

AIM: Disinfection of the toothbrush is an essential parameter for oral hygiene. As a result, especially children can not clean their toothbrushes sufficiently after brushing their teeth. The purpose of this study was to evaluate the accumulation level of Streptococcus mutans colonization at private school nursery-kindergarten children's toothbrushes and evaluate the effectiveness of chlorhexidine solution in four weeks for disinfection. METHODS: This study was approved by the local ethics committee. Two hundred thirty-four private school nursery-kindergarten children were selected for this study, who's aged between 24-72 months. These selected children for this study did not have any dental, antibiotic, antimycotic treatment in the last three months. Before the study, a survey was conducted about parents' education, employment, the income. A pediatric dentist made an oral examination of these children, dental caries, fillings, and missing teeth were determined. Children were divided into two groups; toothbrushes, toothpaste, and practical solutions distilled water and %0,12 chlorhexidine gluconate solution was given in a bottle for four weeks. In addition, the toothbrushes of children were collected every week. After incubation, Streptococcus mutans colonization was evaluated under stereomicroscope. All the collected data were statistically evaluated. RESULTS: The DMF-T scores were statistically significant when evaluated with parents' education and income (p

Statement of the Problem: Ultra-soft bristles are recommended for individuals with gingival recession, dentinal hypersensitivity, and patients who have undergone periodontal surgeries. However, comparative effectiveness of ultra-soft toothbrushes on dental plaque and bleeding indices has not extensively been studied, and a consensus has yet to be reached on their efficacy. Purpose: The aim of this study was to investigate the effect of ultra-soft toothbrushes with different commercial brands on plaque and bleeding indices. Materials and Method: In this crossover randomized clinical trial, 30 participants were selected using convenience sampling method. The subjects were randomly divided into three groups (n=10). In the first session, the bleeding index was recorded. Then each subject was given a toothbrush (Oral B, GUM, or Fuchs), asked to brush at least twice a day using the Bass technique, then avoid brushing for 24 hours after a week and refer for recording the indices. During the second session, bleeding on probing was recorded before brushing, and plaque indices were recorded before and after brushing. Plaque indices before brushing were considered the baseline plaque indices. After one week of washout, each subject used the next toothbrush in terms of the group involved. Turesky plaque index, O’Leary plaque index, and bleeding index were evaluated. The distribution of data was normal. Therefore, ANOVA, t-test, and post hoc tests were used for the analysis of data. Results: The bleeding and plaque indices decreased significantly compared to the baseline with the use of all the three ultra-soft toothbrushes evaluated (p< 0.05), with no significant differences between the three brands (p> 0.05) except for the superiority of Fuchs toothbrush in decreasing the Turesky plaque index. Conclusion: Ultra-soft toothbrushes can reduce plaque index compared to the baseline, but they do not decrease the plaque index up to the optimal level, which might affect their prescription.

Abstract Background While indoor microbiomes impact our health and well-being, much remains unknown about taxonomic and functional transitions that occur in human-derived microbial communities once they are transferred away from human hosts. Toothbrushes are a model to investigate the potential response of oral-derived microbiota to conditions of the built environment. Here, we characterize metagenomes of toothbrushes from 34 subjects to define the toothbrush microbiome and resistome and possible influential factors. Results Toothbrush microbiomes often comprised a dominant subset of human oral taxa and less abundant or site-specific environmental strains. Although toothbrushes contained lower taxonomic diversity than oral-associated counterparts (determined by comparison with the Human Microbiome Project), they had relatively broader antimicrobial resistance gene (ARG) profiles. Toothbrush resistomes were enriched with a variety of ARGs, notably those conferring multidrug efflux and putative resistance to triclosan, which were primarily attributable to versatile environmental taxa. Toothbrush microbial communities and resistomes correlated with a variety of factors linked to personal health, dental hygiene, and bathroom features. Conclusions Selective pressures in the built environment may shape the dynamic mixture of human (primarily oral-associated) and environmental microbiota that encounter each other on toothbrushes. Harboring a microbial diversity and resistome distinct from human-associated counterparts suggests toothbrushes could potentially serve as a reservoir that may enable the transfer of ARGs. Video abstract

Introduction: A toothbrush is the most common oral hygiene aid used, but maintaining and storing the toothbrush hygienically is commonly neglected. In India, people are not aware of the contamination of toothbrushes. Contaminated toothbrushes can act as a vector for the transmission or reinfection of various bacteria, viruses, and fungi. The herbs, which have pharmaceutical properties, can be used as an alternative. The study aimed to compare the antimicrobial efficacy of 3% neem and 3% garlic on Streptococcus mutans and to compare with 0.2% chlorhexidine mouthwash as toothbrush decontaminants. Materials and Methods: A triple-blinded randomized controlled trial was done on 120 subjects. The subjects were divided into four groups: Group I (distilled water), i.e., control, three study groups having 3% neem (Group II), 3% garlic extract (Group III), and 0.2% chlorhexidine gluconate (Group IV). Subjects were provided toothbrushes and toothpaste for both baseline and intervention phases. The toothbrushes were collected after 14 and 28 days for microbial analysis in both phases. The data were analyzed and compared using appropriate t-test and analysis of variance. The level of significance was set at P < 0.05. Results: Garlic (Group III) was most effective at 98%, followed by chlorhexidine (Group IV) 96% and neem (Group II) 88% in reducing the level of S. mutans. Distilled water (Group I) showed only a 3% reduction. Conclusion: Neem and garlic proved to be as effective as chlorhexidine, and these herbal products can be used as an alternative to chlorhexidine as disinfectants for toothbrushes. These are the common ingredients that can be easily found in Indian households. It is herbal, cost-effective, and has no side effects so it can be easily used by every individual as a toothbrush decontaminant.

Aim: The aim of this 12 week, single-blind clinical trial was to compare the efficacy of Manual (Oral-B Pro Health Gum care®), Powered (Oral-B Cross action Power Dual®) and Charcoal (Colgate slim Soft Charcoal®) toothbrushes in plaque control. Materials and Methods: 60 systemically healthy students were selected at random among the students of a Dental College, living under similar environment and dietary conditions. Plaque and calculus were removed professionally and three varieties of toothbrush were distributed among them. Plaque index (PI), sulcus bleeding index (SBI) and gingival index (GI) were assessed at baseline, 3, 6 and 12 weeks. Assessment of colony forming units (CFU) was done at baseline and 12th week. The learning effect over a period of time was also assessed. Results: Over the 12-week period, PI reduced significantly (P < 0.001) with % reduction in plaque from 47% to 59%, 41% to 53% and 45% to 55% for manual, powered and charcoal brush. A significant reduction in GI and SBI was also seen with all the brushes. An insignificant difference in PI, GI and SBI was seen between the brushes. CFU count before and after brushing reduced gradually and statistically significantly (P < 0.001) for all the brushes; however, by end of 12th week period, there was no significant difference (P > 0.05). The learning effect increased from 35% to 60%, 24% to 56% and 31% to 58% for three brushes, respectively, but was more pronounced for powered brush. Conclusion: It can be concluded that all the three brushes (manual, powered and charcoal) are clinically effective in removing plaque, with learning effect more pronounced for powered brush and if proper technique is followed, no brush is superior to the other.

Abstract Background Biting objects was a parafunctional oral habit among children with special care needs. Chewing or biting toothbrushes could expedite the process of toothbrush wear. However, few studies evaluated the deterioration levels of toothbrushes used by children with special needs. This study aimed to assess the deterioration level of toothbrushes used by children with special care needs, and collect parents’ feedbacks to improve the design of children’s toothbrushes. Methods The cross-sectional study recruited 277 children who had special care needs. Children’s toothbrushing behaviors, background information, and parents’ comments on toothbrushes were obtained. Toothbrush deterioration was assessed by bristle wear and bite mark scores. Higher scores indicated severe deterioration. Results Three hundred twenty-one toothbrushes were collected. Children who used 2 to 6 toothbrushes in a 3-month period showed higher toothbrush deterioration scores than children who used a single toothbrush. Over 40% children’s toothbrushes presented excessive wear. Excessive wear was associated with social skills and parents’ education background. Distinct bite marks tended to exist on toothbrushes which had been used by children who showed challenging behaviors during toothbrushing (OR = 1.96, 95%CI1.15–3.32, p

Aim: The aim of the study was to examine oral care given to the patients on mechanical ventilatory support by two different methods on bacterial colonization and oral health. Methods: This study had a design including an experimental and a control group. Sample was composed of 30 patients who had mechanical ventilatory support less than 24 hours. Patients in the experimental group were applied toothbrush and serum physiological; and control group was applied oral care by abeslang and a sponge soaked with NaHCO3. Both groups were given oral care four times a day for four days. Oral health was evaluated by “oral assessment scale”, and bacterial colonization was assessed based on bacteriological culture results of samples taken by cotton swab at days 1 and 4. Results: It was found that almost half of the patients in both groups had insufficient saliva that was more viscous than normal; and dental plaques were decreased among the patients in the experimental group. In terms of bacteria in the oral mucosa, no statistically significant differences were found between the groups based on the comparison of culture results from days 1 and 4. It was found that both methods used for oral care were effective; and they had no superiority over each other. Conclusions: It was concluded that application of regular oral care for the patients on mechanical ventilatory support as part of care protocols decreased bacterial colonization and had a protective and improving effect on oral health.

Plaque biofilm is considered one of the etiological factors involved in the onset of caries and gingivitis, and is associated with the progression of periodontitis and peri-implant inflammation. There is no agreement in the literature on the effectiveness of the oscillating-rotating (OR) powered toothbrush (PTB) and high-frequency sonic (HFS) PTB in improving oral health. Thus, using the present proof-of-concept study we aimed to evaluate the effectiveness of OR PTB versus HFS PTB in terms of the improvement in plaque, gingival inflammation, and lingual patina indexes in dental hygiene university students. Dental hygiene students from the University of Eastern Piedmont “A. Avogadro” of Novara, Italy from November 2019 to October 2021 were recruited. Based on the type of toothbrush previously used for at-home plaque removal, the study participants were divided into two groups: Group 1 (subjects that used MTB prior to the study beginning, asked to use OR PTB for 2 times/day for a minimum of 3 months) and Group 2 (subjects that used HFS PTB prior to the study beginning). All the participants were instructed to avoid floss aids during the study (i.e., pipe cleaners, dental floss, and mouthwash). The outcome measures were: New Method of Plaque Scoring (NMPS), simplified Oral Disease Index (OHI-S), Plaque Control Record (PCR), Gingival Bleeding Index, and Winkel Tongue Coating Index (WTCI). All the outcomes were assessed at baseline (T0) in both groups and after 3 months (T1) in Group 1. Fifty-seven subjects (44 females and 13 males) were included and allocated to the study group (n = 30, 22 females and 8 males) and control group (n = 27, 22 females and 5 males). At T0, all the indexes were significantly higher in Group 2 (p < 0.0001). At T1, NMPS, OHI-S, PCR, GBI, and WTCI were statistically improved in Group 1 (p < 0.0001). Lastly, there was a statistically significant difference between Group 1 at T1 and Group 2 at T0 in terms of NMPS (p = 0.043), OHI-S (p = 0.032), and PCR (p < 0.001). Taken together, the findings of this proof-of-concept study showed the effectiveness over a 3-month period of both oscillating-rotating and sonic PTB in terms of oral health status in a sample of dental hygiene students.

Multiple toothbrush designs have been developed to enhance dental biofilm removal and decrease bacterial contamination and retention over time. Therefore, the aim of this clinical study was to compare the efficacy of a prototype of a new double-sided thermoplastic polyurethane-based toothbrush with that of a conventional nylon-bristle toothbrush. A crossover study was conducted in systemically healthy volunteers (n = 24) for two one-week periods plus one washout week. As outcome variables, plaque and gingival indices, total bacterial contamination of the toothbrushes by quantitative polymerase chain reaction (qPCR), and patient-reported outcomes were measured. Clinical and microbiological variables were analysed using a general linear model and Friedman and Wilcoxon signed-rank tests. No statistically significant differences between toothbrushes were detected neither for full-mouth PlI (p > 0.05) nor for GI (p > 0.05). Similarly, no statistically significant differences were detected for bacterial contamination after 40 seconds or 1 week of use, with results expressed either in CFU/mL or in CFU/mm2 (p > 0.05). In conclusion, the tested prototype toothbrush was as effective and safe as the control toothbrush, and the participating subjects did not experience any adverse effects from its use and rated its efficiency and effectiveness in cleaning their teeth as satisfactory.

Background and Objectives: The aim of this in vitro study was to evaluate the effect of gastric acid associated with the effect of toothbrushing on the surface roughness of different types of composite resin used for direct restorations. Materials and Methods: The materials used in this study were two microhybrid (Filtek Z250, Herculite XRV) and two nanohybrid (Filtek Z550, Herculite XRV Ultra) composite resins. Two hundred and forty cylindrical samples with a height of 2 mm and a diameter of 6 mm were divided into four groups (groups A, B, C and D) corresponding to each tested material (n = 60). Each group was divided in two subgroups: subgroup I—the samples were submersed in hydrochloric acid and immediately submitted to toothbrushing; subgroup II—the samples were submitted only to toothbrushing. The simulation of the acid attack was performed by immersing the samples in a 0.01 M hydrochloric acid solution for 90 min. This procedure was followed immediately by toothbrushing simulation with 10,000 cycles. The acid attack and toothbrushing simulation were performed for two times. The surface roughness evaluation was performed with a Proscan 2100 profilometer. Repeated Measures ANOVA and Bonferroni post-hoc tests were used to perform the statistical analysis. Results: Simulation of one year of toothbrushing associated or not to hydrochloric acid exposure increases the surface roughness of microhybrid and nanohybrid composite resins. Six months of toothbrushing associated to six months of hydrochloric acid exposure increase the surface roughness of nanohybrid composite resins. Conclusions: Microhybrid composite resins surface becomes rougher after toothbrush and acid submersion when comparing to nanohybrid composite resins.

Background and Objectives: The aim of this in vitro study was to evaluate the effect of simulated gastric acid associated with toothbrushing on the surface condition of three resin-modified glass-ionomer cements (RMGIC). Materials and Methods: One hundred and sixty samples of each material were obtained and included in three study groups according to the tested material: Group I (Ionolux, VOCO GmbH, Cuxhaven, Germany); Group II (Vitremer, 3 M-ESPE, St. Paul, MN, USA); and Group III (Fuji II LC, GC Corporation, Tokyo, Japan). The samples were submersed in hydrochloric acid 0.01 M (pH 3.8) for 3 h and exposed to a toothbrushing procedure at a frequency of 10,000 cycles with medium and hard bristles immediately or 30 min after the acid attack. Profilometric measurements were performed by using a non-contact profilometer (Dektak XT, Bruker, Billerica, MA, USA) in order to assess the surface roughness. ANOVA and Bonferroni post hoc tests were used for the statistical analysis at a significance level of p < 0.05. Results: Exposure of RMGICs to the erosive effect of hydrochloric acid in association with toothbrushing 30 min after the chemical attack increased the surface roughness of all three RMGICs. Exposure of the three tested materials exclusively to the action of hydrochloric acid did not affect the surface roughness. Conclusions: One year of hydrochloric acid challenge associated with one year of toothbrushing with medium-hardness bristles performed 30 min after the acid attack increase the surface roughness of two of the three types of RMGIC tested (Ionolux and Fuji II LC).

The aim of this study is to clarify the deflection, splaying, and abrasion of single tufts of polybutylene terephthalate (PBT) toothbrushes after use. A single-center randomized controlled trial is performed. The changes in deflection, bristle splaying, and abrasion are investigated for the middle single tuft of the top line (top–middle tuft) and the middle single tuft of the bottom line (bottom–middle tuft) of PBT toothbrushes with medium stiffness after 1 month, 2 months, and 3 months of use by 34 participants. A soft-material bending-resistance tester is used to assess the deflection of the single tufts. The deflection value of the top–middle tuft significantly increased after 1 month of use compared with the baseline. In contrast, the deflection of the bottom–middle tuft significantly increased after 3 months of use compared with the baseline and after 1 month and 2 months of use. Importantly, the change in deflection was distinctly different between the top– and bottom–middle tufts. The bristle splaying of both tufts significantly increased after use, but a significant change in bristle abrasion was not found. The bending stiffness of the top tuft of a PBT toothbrush may decrease more rapidly than that of the bottom tuft with use.

Background/Aim: Toothbrushes are one of the main means of cleaning teeth and maintaining oral hygiene, but toothbrushes are also potential reservoir of microorganisms, including pathogens. The aim of this paper was to evaluate the oral health, oral hygiene awareness and assess the degree of contamination of toothbrushes among students attending Secondary Medical School.

Background: Toothbrushes are used as an adjunct for mechanical plaque control to improve the oral health and hygiene. However, toothbrushes are an easy source of contamination by the microorganisms. Rinsing with plain tap water may reduce this microbial load, but complete elimination is not possible. Aim: The study aimed to compare the efficacy of three different chemical agents as toothbrush disinfectant. Materials and Methods: A triple-blind randomized controlled trial was conducted in a dental institute. Forty volunteers were divided into three experimental groups and one control group (n = 10). (Group A: 0.2% chlorhexidine; Group B: distilled water; Group C: Listerine; and Group D: 2% sodium hypochlorite). The participants were instructed to brush their teeth using toothbrushes with standard bristles and then disinfect their toothbrushes according to instructed methods. Bacterial decontamination of toothbrushes was measured by calculating colony-forming units (CFUs) of Streptococcus mutans, Staphylococcus, Lactobacillus rhamnosus, and Escherichia coli. Data were statistically analyzed using the SPSS software package for Windows (version 15.0, SPSS Inc., Chicago, IL, USA). Means, standard deviations, and for data of each microorganism after disinfection with different methods were calculated with descriptive statistics. The Bonferroni test was performed for post hoc analysis. A P value of 0.05 was considered as the level of statistical significance. Results: Means were calculated for the CFU in all the groups; Group D (2% sodium hypochlorite) was found to have highest mean reduction for all the microorganisms followed by Group C (Listerine), Group A (0.12% chlorhexidine), and Group B (distilled water) (control group). Conclusion: All the methods tested were effective in reducing the bacterial count of S. mutans, Staphylococcus, L. rhamnosus, and E. coli. However, the most effective method was NaOCl (2%) followed by Listerine, chlorhexidine, and water.

Aim: The aim of this study was to evaluate and compare the efficacy of three types of plaque control methods among 13- to 35-year-old subjects receiving fixed orthodontic treatment in Coorg Institute of Dental Sciences, Virajpet, Coorg district, Karnataka, India. Materials and Methods: A total of 111 subjects who fulfilled the inclusion and exclusion criteria were randomly included in the study. The subjects were recalled after 1 month of the commencement of fixed orthodontic treatment for the recording of baseline data including plaque index (PI), gingival index (GI), and modified papillary bleeding index (MPBI). After recording of the baseline data, the subjects were randomly allocated into each of the intervention groups, i.e., group A (manual tooth brush), group B (powered tooth brush), and group C (manual tooth brush combined with mouthwash) by lottery method. Further, all the subjects were recalled after 1 and 2 months for recording the data. Results: Regarding plaque levels, it was seen that there was a highly statistically significant difference between the three groups (P = 0.001), with the manual tooth brush combined with chlorhexidine mouthwash group recording the lowest mean PI score of 0.5±0.39. A comparison of the mean GI scores among the groups at the end of 2 months shows a highly statistically significant difference (P = 0.001). The mean MPBI scores at the end of 2 months were highly statistically significant among the three groups (P = 0.001), with the group C recording the lowest mean MPBI score of 0.3±0.3. Conclusion: The powered tooth brush group subjects exhibited significantly lesser PI, GI, and MPBI scores than the manual tooth brush group at the end of 2 months, whereas the manual tooth brush combined with chlorhexidine mouth wash group subjects showed maximum improvement, having significantly lesser PI and GI scores than the powered tooth brush group.

Context: Role of toothbrush in decreasing oral microflora. Aims: To evaluate the effectiveness and compare the negative oral microbial flora of dental plaque after the use of a self-contaminated multiple use toothbrush and that of a single-use toothbrush. Settings and Design: Sixty healthy individuals without any systemic conditions. Methods and Materials: The study conducted with 60 participants who were free from any systemic or oral disease and without any adverse habits. In these participants, plaque samples were collected after 1 month use of a self-contaminated multiple use toothbrush. Each participant was given a set of 30 new toothbrushes and a toothpaste tube and instructed to use one toothbrush everyday and discard it after use. The plaque samples were collected on seven days interval and cultured on Mitis Salivarius agar. The colonies were identified and their count was recorded. Statistical Analysis Used: Student t test was applied. Results: Streptococcus mutans, S. sanguis, S. milleri, and Candida were identified from the samples. A highly marked decrease in their numbers was found after the use of a single-use toothbrush over multiple use toothbrushes. Conclusions: As a self-contaminated multiple use toothbrushes can aid microorganisms to grow rapidly into the oral cavity, it may be preferable to change the toothbrush as frequently as possible.

Background: The storage condition of a toothbrush can influence the growth of bacteria. Indonesia as a developing country has a low awareness of the importance of toothbrush hygiene. Thus, an efficient and economic toothbrush storage solution is needed. Objective: The aim of this study was to evaluate the effect of soaking toothbrushes in mouthwash solution on the total number of Streptococcus mutans and Fusobacterium on the toothbrush. Methods: Eighteen toothbrushes were provided to healthy individuals aged 19–23-years. For 1 month, each toothbrush was soaked in disinfectant solution (25 mL) for 20 min after brushing, with Group 1 using mouthwash and Group 2 using sterile tap water. The real-time polymerase chain reaction (PCR) method was used to evaluate the number of microorganisms on each toothbrush. The total number of DNA targets was identified using real-time PCR followed by SYBR Green reagents and 16S rRNA-gene specific primers for S. mutans and Fusobacterium. A paired sample t-test was used for statistical analysis, and the level of significance was set at P < 0.05. Results: There were significant differences in the total bacterial numbers of S. mutans and Fusobacterium on toothbrushes after soaking with mouthwash solution. The average scores (Log10-CFU/mL ± standard deviation) of the total bacteria (2.66 ± 0.39), S. mutans (1.21 ± 0.18), and Fusobacterium (10.35 ± 6.02) on toothbrushes in Group 1 were significantly decreased compared to the average scores of the total bacterial load (5.19 ± 0.41), S. mutans (2.71 ± 1.59), and Fusobacterium (18.96 ± 4.26) in Group 2. Statistical evaluation brought statistically significant difference of total bacteria numbers and S. mutans between Group 1 and Group 2 (P < 0.05). Conclusion: Soaking toothbrushes in mouthrinse solution reduce the total number of bacterial load, S. mutans, and Fusobacterium. Further studies are needed to explore the effects of mouthwash solution against other oral pathogens.