Plaque removal equal regardless of toothbrush

Preventive Dentistry Plaque removal equal regardless of toothbrush Background.—Young healthy children have seldom been included in investigations of the effectiveness of electric toothbrushes. Important factors in determining effectiveness include the time spent brushing and gingival health, as well as plaque removal efficacy. A small-head powered toothbrush was used for 60 seconds, another electric toothbrush was used for 2 minutes, and a manual toothbrush was used for 2 minutes. The effectiveness of each was measured with respect to plaque removal and reduction in gingivitis in children younger than age 6. Methods.—The small-head Oralgiene 60 Second Time Machine was compared with the Braun Oral-B Mickey Mouse powered toothbrush and an Oral-B Rugrats 20 manual toothbrush. Fifty-eight children age 4 to 5 years were randomly assigned to use 1 of the 3 toothbrushes. All subjects had plaque and gingival status determined at a visit, then did not brush for 24 hours. After the 24 hours, the children had plaque indices measured, brushed with their toothbrushes, then had plaque indices measured again. Plaque and gingival indices were recorded after 6 weeks of brushing with the assigned brushes. Plaque reduction after 1-time use and plaque and gingival inflammation reduction after 6 weeks were the measurements sought. Results.—Toothbrush type and changes in the gingival score between baseline and the 6-week analysis showed a statistically significant interaction. Compared with the manual and the Oral-B toothbrushes, the Oralgiene toothbrush produced a greater reduction in gingival score. In addition, significantly different whole-mouth plaque scores were found after the 1-time use. The Oralgiene achieved a significantly lower mean plaque score at this point than the manual and the Oral-B toothbrushes. None of the toothbrushes produced a decline in facial plaque significantly greater than

the others. It was not clinically meaningful, but lingual plaque removal was significantly better for the Oralgiene toothbrush than for the manual and Oral-B toothbrushes. After 6 weeks, the Oral-B toothbrush produced significantly lower whole-mouth adjusted mean plaque scores and significantly lower facial adjusted mean plaque scores than either the manual or the Oralgiene toothbrush. These measures were not clinically meaningful. Lingual plaque reduction scores were the same regardless of the toothbrush used. The Oralgiene toothbrush did have a higher compressive load than the Oral-B toothbrush. Discussion.—For the 1-time-use trial, the Oralgiene toothbrush produced significantly better plaque removal than the manual or the Oral-B toothbrush. However, longterm, the Oral-B showed better plaque scores than the Oralgiene or the manual toothbrush. Overall, no clinically meaningful differences were noted between the 3 toothbrushes tested.

Clinical Significance.—Two powered and 1 manual brush were compared. Differences in effectiveness can be demonstrated for each, but no clinically significant differences were noted during the 5 to 7 weeks of the test.

Silverman J, Rosivack RG, Matheson PB, et al: Comparison of powered and manual toothbrushes for plaque removal by 4- to 5-year-old children. Pediatr Dent 26:225-230, 2004 Reprints available from J Silverman; e-mail: drjoeysilverma @yahoo.com

Self-etching adhesive effective in obtaining strong bond Background.—Unlike glass ionomer sealants, resin sealants have excellent retention and have been recommended for use in caries-susceptible teeth. The fluoride released from glass ionomer sealants even after part of the material is lost exerts some caries preventive effect, but

58 Dental Abstracts

resin sealants have superior ability in this area. Because patient behavior and compliance are significant contributors to the success of sealants, use of the self-etching adhesives, which have no need for rinsing and diminish both treatment time and the degree of patient compliance required,