title: Efficacy of plaque removal and learning effect of a powered and a manual toothbrush.
abstract: BACKGROUND
  Subjects with high plaque and gingivitis scores can profit most from the introduction of new manual or powered tooth brushes. To improve their hygiene, not only the technical characteristics of new brushes but also the learning effect in efficient handling are of importance.
  
  
  OBJECTIVE
  : The present study compared the efficacy in plaque removal of an electric and a manual toothbrush in a general population and analysed the learning effect in efficient handling.
  
  
  METHODS
  Eighty healthy subjects, unfamiliar with electric brushes, were divided into two groups: group 1 used the Philips/Jordan HP 735 powered brush and group 2 used a manual brush, Oral-B40+. Plaque index (PI) and gingival bleeding index (GBI) were assessed at baseline and at weeks 3, 6, 12 and 18. After each evaluation, patients abstained from oral hygiene for 24 h. The next day a 3-min supervised brushing was performed. Before and after this brushing, PI was assessed for the estimation of the individual learning effect. The study was single blinded.
  
  
  RESULTS
  Over the 18-week period, PI reduced gradually and statistically significantly (p<0.001) in group 1 from 2.9 (+/-0.38) to 1.5 (+/-0.24) and in group 2 from 2.9 (+/-0.34) to 2.2 (+/-0.23). From week 3 onwards, the difference between groups was statistically significant (p<0.001). The bleeding index decreased in group 1 from 28% (+/-17%) to 7% (+/-5%) (p<0.001) and in group 2 from 30% (+/-12%) to 12% (+/-6%) (p<0.001). The difference between groups was statistically significant (p<0.001) from week 6 onwards. The learning effect, expressed as the percentage of plaque reduction after 3 min of supervised brushing, was 33% for group 1 and 26% for group 2 at week 0. This percentage increased at week 18 to 64% in group 1 and 44% in group 2 (difference between groups statistically significant: p<0.001).
  
  
  CONCLUSIONS
  The powered brush was significantly more efficient in removing plaque and improving gingival health than the manual brush in the group of subjects unfamiliar with electric brushes. There was also a significant learning effect that was more pronounced with the electric toothbrush.
authors.affiliation: Department of Periodontology, Conservative Dentistry, Dental School, Carol Davila University, Bucharest, Romania.
authors.forename: D
authors.initials: D
authors.lastname: Lazarescu
authors.forename: S
authors.initials: S
authors.lastname: Boccaneala
authors.forename: A
authors.initials: A
authors.lastname: Illiescu
authors.forename: J A
authors.initials: JA
authors.lastname: De Boever
mesh_terms: D000328:Adult; D003773:Dental Plaque / Q000628:therapy*; D003774:Dental Plaque Index; D004560:Electricity; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene / Q000193:education*; D010512:Periodontal Index; D016037:Single-Blind Method; D014099:Toothbrushing / Q000295:instrumentation*