title: Brushing skills and plaque reduction using single- and triple-headed toothbrushes.
abstract: OBJECTIVE
  To evaluate the effect of toothbrush design on brushing skills and plaque removal among young healthy adults.
  
  
  METHODS
  A population of 200 healthy young adults was approached. Patients were randomly assigned to one of two research groups: one used a manual single-headed toothbrush, while the other used a manual triple-headed toothbrush. At the start of the study, participants were asked to brush their teeth using the provided toothbrush with no prior guidance or instructions. Plaque Index (PI) was measured. Immediately afterward, participants were personally instructed on how to brush their teeth using the provided toothbrush. Toothbrushing performance skill was evaluated and scored using the toothbrushing performance skill index (TB-PS-I/Ashkenazi index) following the first brushing, as well as on a recall visit 1 week later.
  
  
  RESULTS
  Following the first, uninstructed brushing, PI values ranged from 0.41 to 1.33, with higher plaque scores for the single-headed toothbrush group. One week after receiving brushing instructions, PI decreased in the both toothbrush groups and ranged between 0.12 and 0.81, with higher PI scores for the single-headed toothbrush group. Following the first, uninstructed brushing, total TB-PS-I scores, as well as component scores ("reaching" and "staying") showed no difference between the two toothbrush groups. One week after receiving brushing instructions, the TB-PS-I in the triple-headed toothbrush group was significantly higher than that in the single-headed toothbrush group.
  
  
  CONCLUSIONS
  The triple-headed toothbrush was found to promote easier toothbrushing and plaque removal both before and after receiving toothbrushing instructions.
authors.affiliation: Faculty of Medicine, Technion IIT, Haifa, Israel. liranl@technion.ac.il
authors.forename: Liran
authors.initials: L
authors.lastname: Levin
authors.forename: Yael
authors.initials: Y
authors.lastname: Marom
authors.forename: Malka
authors.initials: M
authors.lastname: Ashkenazi
mesh_terms: D000293:Adolescent; D003773:Dental Plaque / Q000628:therapy*; D003774:Dental Plaque Index; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009048:Motor Skills; D009910:Oral Hygiene; D010353:Patient Education as Topic; D014099:Toothbrushing / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult