title: Approximal brush head used on a powered toothbrush.
abstract: OBJECTIVE
  This study was designed to test whether the approximal efficacy of a powered toothbrush (Braun Oral-B 3D Plaque Remover) can be improved when a pointed-shaped brush head (PBH) specifically designed for these approximal areas is used as compared with the standard cup-shaped brush head (CBH).
  
  
  METHODS
  Forty non-dental students were included. They all received the powered toothbrush and two different brush heads (CBH+PBH). Instructions were given to use each brush head twice every day (2 min. with the CBH followed by 1 min. with the PBH). Two weeks later they received an appointment for the first experiment (Exp 1), prior to which they abstained from all oral hygiene procedures for 48 h. Plaque was assessed at 6 sites/tooth. Next, the dental hygienist brushed for 2 min. (30 s/quadrant) with the CBH. Plaque was scored again. Subsequently, the dental hygienist brushed the approximal areas for another minute: in two randomly selected contra-lateral quadrants for 30 s with the CBH and in the opposing quadrants for 30 s with the PBH. The next approximal plaque was scored a third time. After 2-3 weeks, Exp 2 was carried out comparable to Exp 1; only this time the panelists brushed themselves.
  
  
  RESULTS
  Exp 1 showed approximal plaque scores at the baseline of 1.70 and 1.72 and at post-brushing 0.21 and 0.26 for the CBH + PBH and CBH only, respectively (p<0.05). The additional increase in approximal plaque reduction after 30 s of brushing with PBH was 22% and for the CBH 19% (p<0.05). Exp 2 showed approximal plaque scores at baseline of 1.76 and 1.74 and post-brushing of 0.21 and 0.24 for the CBH+PBH and the CBH, respectively. The additional approximal plaque reduction of 30 s brushing with PBH was 19% and 18% with the CBH (no significant difference).
  
  
  CONCLUSIONS
  An additional 1 min. showed minor differences (1-3%) between brush heads. The effect of the 1 min. extra brushing (+/-18%) itself was much larger. It seems therefore beneficial to advise the patient to brush longer. A second different brush head may stimulate to do so.
authors.affiliation: Department of Periodontology, ACTA, Academic Center for Dentistry Amsterdam, Amsterdam, 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: M
authors.initials: M
authors.lastname: Piscaer
authors.forename: Y
authors.initials: Y
authors.lastname: Ijzerman
authors.forename: U
authors.initials: U
authors.lastname: van der Velden
mesh_terms: D003773:Dental Plaque / Q000473:pathology / Q000628:therapy*; D003774:Dental Plaque Index; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D009910:Oral Hygiene; D010353:Patient Education as Topic; D016037:Single-Blind Method; D013499:Surface Properties; D013997:Time Factors; D019228:Tooth Crown / Q000473:pathology; D014099:Toothbrushing / Q000295:instrumentation*