title: Effects of toothbrushes with tapered and cross angled soft bristle design on dental plaque and gingival inflammation: a randomized and controlled clinical trial.
abstract: OBJECTIVE
  To investigate the effect of three manual toothbrushes on dental plaque and gingival inflammation.
  
  
  METHODS
  The elmex Sensitive Extra Soft (ESES), elmex Sensitive Soft (ESS) and an ADA standard toothbrush (ADAS) were evaluated in a randomized clinical trial. Subjects brushed twice daily in their usual manner. Plaque index (PI), gingival index (GI) and plaque and gingival scores of interproximal spaces (IntPI and IntGI) were evaluated at day 15 and day 30. ANOVA and t-test were used to compare plaque and gingival scores.
  
  
  RESULTS
  A total of 84 subjects with mild to moderate gingivitis completed the study. Plaque and gingival scores in ESES and ESS groups decreased from baseline to day 15 and day 30. At day 30, subjects in both ESES and ESS groups had lower plaque and gingival scores than those in the ADAS group (p<0.05). In the ESES group, PI reduced by 13.6% (p<0.0001), and GI by 10.5% (p<0.0001) at day 30 when compared to the baseline scores. In the ESS group, PI reduced by 11.8% (p<0.0001), and GI by 12.0% (p<0.0001) at day 30. The reduction in IntPI and IntGI scores were comparable to those of the overall PI and GI. In contrast, there were no changes in PI, GI, and IntPI and IntGI scores between baseline and the day 15 and day 30 evaluations in the ADAS group.
  
  
  CONCLUSIONS
  Both the ESES and ESS toothbrushes are more effective in removing dental plaque and reducing gingival inflammation than the ADA standard toothbrush.
authors.affiliation: University of Rochester Eastman Dental Center, 625 Elmwood Avenue, Rochester, NY 14620, United States. yanfang_ren@urmc.rochester.edu
authors.forename: Yan-Fang
authors.initials: YF
authors.lastname: Ren
authors.forename: Rita
authors.initials: R
authors.lastname: Cacciato
authors.forename: Mary Therese
authors.initials: MT
authors.lastname: Whelehan
authors.forename: Li
authors.initials: L
authors.lastname: Ning
authors.forename: Hans Sigurd
authors.initials: HS
authors.lastname: Malmstrom
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003742:Dental Devices, Home Care; D003773:Dental Plaque / Q000628:therapy*; D004812:Epidemiologic Methods; D005260:Female; D005891:Gingivitis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014099:Toothbrushing / Q000009:adverse effects / Q000295:instrumentation*