title: The effect of brushing time and dentifrice on dental plaque removal in vivo.
abstract: OBJECTIVE
  Routine toothbrushing is the principal method by which individuals remove plaque and control plaque-related diseases, such as periodontitis and caries. Oral health care professionals generally recommend at least 2 minutes brushing with an appropriate technique, and yet the average brushing time in the general population is closer to 45 seconds. Our understanding of the relationship between brushing time and plaque removal, in an untutored general population using a conventional manual toothbrush and dentifrice, is limited. The role of dentifrice in plaque removal is also unclear.
  
  
  METHODS
  This study was undertaken to measure plaque removal during untutored brushing over timed periods between 30 and 180 seconds with 1.5 g dentifrice, using an Aquafresh Flex brush and Aquafresh Advanced dentifrice. Plaque removal after brushing without dentifrice was also determined (at the 60 second time point only). Forty-seven subjects participated in the study, in which plaque level was assessed using the Quigley-Hein (Turesky-modification) Index.
  
  
  RESULTS
  Plaque removal increased with brushing time across the range studied, tending towards a maximum at longer brushing times. At the extremes, brushing for 180 seconds removed 55% more plaque than brushing for 30 seconds. Brushing for 120 seconds removed 26% more plaque than brushing for 45 seconds. The use of dentifrice did not increase plaque removal during 60 seconds of brushing.
  
  
  CONCLUSIONS
  Oral health care professionals should reinforce efforts to persuade patients to brush for longer periods of time, as increasing brushing time to the consensus minimum of 2 minutes from a more typical 45 seconds increases plaque removal to an extent likely to provide clinically significant oral health benefits.
authors.affiliation: Medical Group GlaxoSmithKline Consumer Healthcare, Weybridge, UK.
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Creeth
authors.forename: Andrew
authors.initials: A
authors.lastname: Gallagher
authors.forename: Joseph
authors.initials: J
authors.lastname: Sowinski
authors.forename: James
authors.initials: J
authors.lastname: Bowman
authors.forename: Kathy
authors.initials: K
authors.lastname: Barrett
authors.forename: Shirley
authors.initials: S
authors.lastname: Lowe
authors.forename: Kartik
authors.initials: K
authors.lastname: Patel
authors.forename: Mary Lynn
authors.initials: ML
authors.lastname: Bosma
mesh_terms: D000293:Adolescent; D000328:Adult; D018592:Cross-Over Studies; D003742:Dental Devices, Home Care; D003773:Dental Plaque / Q000628:therapy*; D003774:Dental Plaque Index; D003802:Dentifrices / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014099:Toothbrushing / Q000295:instrumentation* / Q000379:methods*; D055815:Young Adult
chemical_list: D003802:Dentifrices