Effectiveness of low cost toothbrushes, with or without dentifrice, in the removal of bacterial plaque in deciduous teeth

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Abstract

The main objective of this study was to compare the effectiveness of a low cost toothbrush ("monoblock") to that of a conventional toothbrush with and without addition of dentifrice with respect to the removal of dental plaque. Thirty-two 4- to 6-year-old children took part in this study: they were evaluated under four experimental conditions defined by the combinations of the values of two factors, toothbrush (conventional or monoblock) and use of dentifrice (with or without). The effectiveness of the treatments was defined in terms of the reduction of a bacterial plaque index evaluated before and after toothbrushing. No statistically significant differences were detected between the two types of toothbrushes with respect to the reduction of the bacterial plaque index. Similarly, there were no statistical evidences that the use of dentifrice improves the mechanical control of dental plaque. These results are important from a public health point of view, specially in developing countries, where the dissemination of educational and preventive techniques of low cost are fundamental.

Translated abstract

O principal objetivo deste estudo foi comparar a efetividade de uma escova dental de baixo custo (monobloco) à efetividade de uma escova convencional, com ou sem adição de dentifrício, em relação à remoção da placa dentária.Participaram deste estudo trinta e duas crianças de 4 a 6 anos de idade, que foram avaliadas sob quatro condições experimentais, definidas pela combinação de dois fatores: escova dental (convencional ou monobloco) e uso de dentifrício (com ou sem dentifrício). A efetividade dos tratamentos foi definida em termos de redução do índice de placa bacteriana, avaliado antes e após a escovação.Não foram encontradas diferenças estatisticamente significativas entre os dois tipos de escovas no que diz respeito à redução de placa bacteriana. Similarmente, não houve evidências estatísticas de que o uso de dentifrício aumenta o controle mecânico da placa. Esses resultados são importantes do ponto de vista de saúde pública, principalmente em países em desenvolvimento, onde a disseminação de técnicas educacionais e preventivas de baixo custo são fundamentais.

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Most cited references 26

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Mechanical devices versus antimicrobial rinses in plaque and gingivitis reduction.

P Finkelstein, K Yost, E. Grossman (1990)

The effectiveness of mechanical oral cleaning and oral antimicrobial rinses was compared for gingivitis and bacterial plaque control in 158 subjects. Teeth were brushed ad lib throughout; four of the five groups used either an interdental cleaner, dental floss, an essential oil mouthwash or a cetypyridinium mouthwash. Gingival bleeding (EIBI), visual inflammation (VGI), and tooth plaque coverage were evaluated at zero, six and 12 weeks of product use. After six weeks, bleeding reduction was 42% greater for the interdental cleaner and 21% greater for the dental floss than for the control. All groups showed a further decrease after 12 weeks, but only the 49% reduction of the interdental cleaner was significantly greater than the control. The rinses showed no more reduction in bleeding sites than the control throughout the study. VGI scores were no different from the control for any of the groups. However, the EIBI proved much more sensitive than the visual method finding three times as many inflamed sites. Plaque was reduced by both antimicrobial rinses 27% more than the control over 12 weeks; the interdental cleaner and dental floss groups showed no significant incremental plaque reductions. The results suggest antimicrobial rinses reduce plaque on visible tooth surfaces, but do not penetrate sufficiently between teeth to affect interdental plaque and thus interdental inflammation. However, by disturbing interdental plaque, both dental floss and the interdental cleaner have little effect on visible tooth surface plaque accumulation, yet produce a significant reduction in gingival inflammation.