title: Influence of a controlled pressure system on toothbrushing behavior.
abstract: The use of excessive brushing force has been shown to be a major cause of gingival abrasion. To aid in preventing over-vigorous brushing, the Philips/Jordan electric toothbrush incorporates a Controlled Pressure system (CPS) that causes the brush head to flex back when a toothbrushing force (TBF) in excess of a pre-determined threshold is exerted against the teeth or soft tissues. Two studies (I/II) were conducted to determine whether this mechanical feedback system is sufficiently sensitive to enable users to control their brushing behavior. In Study I, the learning pattern of brushing behavior as a response to the feedback system was evaluated. Seventeen subjects were asked to brush their teeth under observation at least twice a day for a two-week period. During these observations, the number of clicks, as well as the time the brush was pushed "through the click" were recorded. Ten of seventeen volunteers demonstrated a clear learning behavior; the mean number of clicks/minute (for all subjects) was reduced from 10 to 4 after 10 sessions of brushing, and then to 2 or 3 clicks at the end of two weeks. In Study II, 46 subjects used the electric toothbrush with the CPS click force set at various levels between 150-420 g (at 30 g intervals). After a 4-week learning period, the mean TBF was determined in each subject. TBF was most strongly influenced at pre-set click forces between 180 and 270 g. The mean TBF was lowest (about 80 g) when the threshold was set at 210 or 240 g; it then increased (to about 130-140 g TBF) both for smaller and larger values of the threshold setting. Hence, both studies indicate that the Controlled Pressure system is a functional feature that can be used to control the habitual brushing force in a learning period of less than 2 weeks.
authors.affiliation: Department of Restorative Dentistry, University of Newcastle, Newcastle upon Tyne, UK. p.a.heasman@newcastle.ac.uk
authors.forename: P A
authors.initials: PA
authors.lastname: Heasman
authors.forename: I
authors.initials: I
authors.lastname: Heynderickx
authors.forename: M
authors.initials: M
authors.lastname: de Jager
authors.forename: D
authors.initials: D
authors.lastname: Sturm
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003742:Dental Devices, Home Care; D004582:Electronics, Medical / Q000295:instrumentation; D004867:Equipment Design; D005246:Feedback; D005881:Gingiva / Q000293:injuries; D015438:Health Behavior; D006801:Humans; D007858:Learning; D016014:Linear Models; D017711:Nonlinear Dynamics; D018583:Pliability; D011312:Pressure; D013016:Sound; D013314:Stress, Mechanical; D013997:Time Factors; D014099:Toothbrushing / Q000295:instrumentation / Q000379:methods*; D014110:Touch; D014741:Video Recording