title: Relationship between the plaque removal efficacy of a manual toothbrush and brushing force.
abstract: This survey investigated the association between the efficacy of plaque removal and toothbrushing forces during a normal brushing regime. The 94 subjects participating in this study were requested not to brush 24 h prior to the experiment. Panelists brushed for 1 min with a manual toothbrush. Before and after brushing, plaque was assessed using the Turesky modification of the Quigley & Hein plaque index. A second 1-min exercise of brushing was carried out to assess the toothbrushing force. The mean plaque reduction was 39%, with vestibular surfaces being cleaned most effective (69%) and the lingual surfaces the least (21%). The mean brushing force was 330 g. No correlation was observed between efficacy and brushing force (r=0.14, p=0.16). The relationship between pre- and post-brushing plaque was stronger (r=0.68, p<0.001). Multiple regression analysis entering squared values of force as an independent variable into the equation, indicated that the relation between efficacy and force was not linear. A curve could be fitted to the plot (p=0.0004), demonstrating that up to a certain level of force, an increase of force is associated with an increase in efficacy (r=0.33, p<0.01). Beyond this point, application of higher forces resulted in reduced efficacy (r=-0.49, p=0.03). As was calculated in this particular test this 'transition' level of force was 407.4 g. The absence of a correlation between brushing force and plaque removal efficacy suggests that in a 'user model' brushing situation, other factors than brushing force are of major influence on the amount of plaque removed.
authors.affiliation: Department of Periodontology, Academic Centre for Dentistry Amsterdam, ACTA, The Netherlands. GA.vd.Weijden@acta.nl
authors.forename: G A
authors.initials: GA
authors.lastname: Van der Weijden
authors.forename: M F
authors.initials: MF
authors.lastname: Timmerman
authors.forename: M M
authors.initials: MM
authors.lastname: Danser
authors.forename: U
authors.initials: U
authors.lastname: Van der Velden
mesh_terms: D003773:Dental Plaque / Q000473:pathology / Q000628:therapy*; D003774:Dental Plaque Index; D003802:Dentifrices / Q000627:therapeutic use; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D012044:Regression Analysis; D012815:Signal Processing, Computer-Assisted; D013314:Stress, Mechanical; D014070:Tooth / Q000473:pathology; D014099:Toothbrushing / Q000295:instrumentation* / Q000379:methods; D014159:Transducers
chemical_list: D003802:Dentifrices