title: Interproximal plaque mass and fluoride retention after brushing and flossing--a comparative study of powered toothbrushing, manual toothbrushing and flossing.
abstract: OBJECTIVE
  To determine differences in interproximal plaque mass and fluoride retention with different modes of toothbrushing and flossing.
  
  
  METHODS
  Forty-seven subjects in good health used four treatments in a four-period, randomized, crossover design: 1) manual brushing only; 2) manual brushing and daily flossing; 3) electric brushing using a rotational oscillation toothbrush; and 4) electric brushing using a sonic toothbrush. Subjects used a standard sodium fluoride dentifrice during the eight-day experimental periods and a fluoride-free dentifrice during the seven-day washout periods between treatments. Interproximal plaque samples were taken on Day 1 and on Day 8, weighed, and analyzed for fluoride content.
  
  
  RESULTS
  The amount of interproximal plaque was lowest with sonic brushing, which left 43-65% less plaque than all other treatments. Manual brushing and flossing yielded less plaque than manual brushing alone and rotational oscillation brushing. Differences were statistically significant (p < 0.05) for treatment; there was no time effect on plaque mass. For fluoride retention, at Day 1 sonic brushing gave at least 54% more fluoride in the interproximal plaque than all other treatments, which was significant. All treatments demonstrated a significant increase in fluoride concentration with time except manual brushing and flossing, which showed a significant decrease. At Day 8, the fluoride concentration was significantly higher for sonic brushing than for manual brushing or rotational oscillation brushing by over 40%, and all treatments exhibited significantly greater fluoride than the manual brushing and flossing combination.
  
  
  CONCLUSIONS
  The mode of toothbrushing may impact the amount of plaque retained interproximally and its fluoride concentration.
authors.affiliation: Department of Cariology, Faculty of Odontology, Göteborg University, Göteborg, Sweden. sjogren@odontologi.gu.se
authors.forename: Karin
authors.initials: K
authors.lastname: Sjögren
authors.forename: Ann-Britt
authors.initials: AB
authors.lastname: Lundberg
authors.forename: Dowen
authors.initials: D
authors.lastname: Birkhed
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Dudgeon
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Johnson
mesh_terms: D000328:Adult; D002327:Cariostatic Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D018592:Cross-Over Studies; D003742:Dental Devices, Home Care; D003773:Dental Plaque / Q000378:metabolism / Q000473:pathology*; D003802:Dentifrices / Q000627:therapeutic use; D004867:Equipment Design; D005260:Female; D005459:Fluorides / Q000493:pharmacokinetics* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D012969:Sodium Fluoride / Q000627:therapeutic use; D014070:Tooth / Q000473:pathology; D014099:Toothbrushing / Q000295:instrumentation / Q000379:methods*
chemical_list: D002327:Cariostatic Agents; D003802:Dentifrices; D012969:Sodium Fluoride; D005459:Fluorides