SpringerLink
Log in

Professional brushing study comparing the effectiveness of sonic brush heads with manual toothbrushes: a single blinded, randomized clinical trial

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

The aim of this study was to evaluate the plaque removal efficacy of four toothbrushes: the Philips Sonicare Elite with medium and mini brush heads, the Elmex Sensitive, and the American Dental Association (ADA) reference toothbrush. This study was a randomized, controlled, investigator-blinded, four-brush crossover design study, which examined plaque removal following a consecutive repeated use. All brushes were used on each participant in a randomly assigned quadrant of the mouth. A total of 90 subjects participated in the study. Prior to the experiment, they received a professional prophylaxis and were requested to refrain from toothbrushing for 48 h. Teeth were professionally brushed consecutively for 10 to 90 s per quadrant. A Turesky-modified Quigley Hein Index score was assessed at baseline and after each brushing interval by one blinded investigator. Results showed reduction of mean plaque scores for all brushes with time from 10 to 90 s. After 30 s (2-min whole mouth equivalent) of brushing, the Sonicare brushes cleaned 19, the ADA brush 16, and the Elmex Sensitive 10 of in average 28 tooth surfaces. With time, the number of additional cleaned surfaces decreased. Time is an important variable in the evaluation of plaque-removing efficacy since absolute efficacy increases with time and differs per toothbrush. No differences could be found between the two brush heads of the Sonicare.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Thailand)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Westfelt E (1996) Rationale of mechanical plaque control. J Clin Periodontol 23:263–267

    Article  PubMed  Google Scholar 

  2. Haffajee AD, Smith C, Torresyap G, Thompson M, Guerrero D, Socransky SS (2001) Efficacy of manual and powered toothbrushes (II). Effect on microbiological parameters. J Clin Periodontol 28:947–954

    Article  PubMed  Google Scholar 

  3. Sharma NC, Lyle DM, Qaqish JG, Galustians J (2006) Evaluation of the plaque removal efficacy of three power toothbrushes. J Int Acad Periodontol 8:83–88

    PubMed  Google Scholar 

  4. Penick C (2004) Power toothbrushes: a critical review. Int J Dent Hyg 2:40–44

    Article  PubMed  Google Scholar 

  5. Moritis K, Delaurenti M, Johnson MR, Berg J, Boghosian AA (2002) Comparison of the Sonicare Elite and a manual toothbrush in the evaluation of plaque reduction. Am J Dent 15 Spec No:23B–25B

    Google Scholar 

  6. Haffajee AD, Thompson M, Torresyap G, Guerrero D, Socransky SS (2001) Efficacy of manual and powered toothbrushes (I). Effect on clinical parameters. J Clin Periodontol 28:937–946

    Article  PubMed  Google Scholar 

  7. Forrest JL, Miller SA (2004) Manual versus powered toothbrushes: a summary of the Cochrane Oral Health Group's Systematic Review. Part II. J Dent Hyg 78:349–354

    PubMed  Google Scholar 

  8. Forrest JL, Miller SA (2004) The anatomy of evidence-based publications: article summaries and systematic reviews. Part I. J Dent Hyg 78:343–348

    PubMed  Google Scholar 

  9. Heanue M, Deacon SA, Deery C, Robinson PG, Walmsley AD, Worthington HV, Shaw WC (2003) Manual versus powered toothbrushing for oral health. Cochrane Database Syst Rev:CD002281

  10. Moritis K, Jenkins W, Hefti A, Schmitt P, McGrady M (2008) A randomized, parallel design study to evaluate the effects of a Sonicare and a manual toothbrush on plaque and gingivitis. J Clin Dent 19:64–68

    PubMed  Google Scholar 

  11. Biesbrock AR, Bartizek RD, Walters PA, Warren PR, Cugini M, Goyal CR, Qaqish J (2007) Clinical evaluations of plaque removal efficacy: an advanced rotating-oscillating power toothbrush versus a sonic toothbrush. J Clin Dent 18:106–111

    PubMed  Google Scholar 

  12. Putt MS, Milleman JL, Jenkins W, Schmitt P, Master AS, Strate J (2008) A randomized crossover-design study to investigate the plaque removal efficacy of two power toothbrushes: Philips Sonicare Flexcare and Oral-B Triumph. Compend Contin Educ Dent 29:56–58

    PubMed  Google Scholar 

  13. van der Weijden GA, Timmerman MF, Piscaer M, Ijzerman Y, Van der Velden U (2004) Plaque removal by professional electric toothbrushing compared with professional polishing. J Clin Periodontol 31:903–907

    Article  PubMed  Google Scholar 

  14. Weaks LM, Lescher NB, Barnes CM, Holroyd SV (1984) Clinical evaluation of the Prophy-Jet as an instrument for routine removal of tooth stain and plaque. J Periodontol 55:486–488

    PubMed  Google Scholar 

  15. Quigley GA, Hein JW (1962) Comparative cleansing efficiency of manual and power brushing. J Am Dent Assoc 65:26–29

    PubMed  Google Scholar 

  16. Turesky S, Gilmore ND, Glickman I (1970) Reduced plaque formation by the chloromethyl analogue of victamine C. J Periodontol 41:41–43

    PubMed  Google Scholar 

  17. Feil PH, Grauer JS, Gadbury-Amyot CC, Kula K, McCunniff MD (2002) Intentional use of the Hawthorne effect to improve oral hygiene compliance in orthodontic patients. J Dent Educ 66:1129–1135

    PubMed  Google Scholar 

  18. McCracken GI, Heasman L, Stacey F, Kelly PJ, Heasman PA (2000) Testing the efficacy of plaque removal of a prototype brush head for a powered toothbrush. J Clin Periodontol 27:542–548

    Article  PubMed  Google Scholar 

  19. McCarney R, Warner J, Iliffe S, van Haselen R, Griffin M, Fisher P (2007) The Hawthorne Effect: a randomised, controlled trial. BMC Med Res Methodo 7:30

    Article  Google Scholar 

  20. Fox NS, Brennan JS, Chasen ST (2008) Clinical estimation of fetal weight and the Hawthorne effect. Eur J Obstet Gynecol Reprod Biol 141:111–114

    Article  PubMed  Google Scholar 

  21. Bergenholtz A, Gustafsson LB, Segerlund N, Hagberg C, Ostby N (1984) Role of brushing technique and toothbrush design in plaque removal. Scand J Dent Res 92:344–351

    PubMed  Google Scholar 

  22. van der Weijden GA, Timmerman MF, Nijboer A, Lie MA, van der Velden U (1993) A comparative study of electric toothbrushes for the effectiveness of plaque removal in relation to toothbrushing duration. Timerstudy. J Clin Periodontol 20:476–481

    Article  PubMed  Google Scholar 

  23. Carvalho RS, Rossi V, Weidlich P, Oppermann RV (2007) Comparative analysis between hard- and soft-filament toothbrushes related to plaque removal and gingival abrasion. J Clin Dent 18:61–64

    Google Scholar 

  24. Versteeg PA, Piscaer M, Rosema NA, Timmerman MF, van der Velden U, van der Weijden GA (2008) Tapered toothbrush filaments in relation to gingival abrasion, removal of plaque and treatment of gingivitis. Int J Dent Hyg 6:174–182

    Article  PubMed  Google Scholar 

  25. Versteeg PA, Rosema NA, Timmerman MF, van der Velden U, van der Weijden GA (2008) Evaluation of two soft manual toothbrushes with different filament designs in relation to gingival abrasion and plaque removing efficacy. Int J Dent Hyg 6:166–173

    Article  PubMed  Google Scholar 

  26. Zero DT, Raubertas RF, Fu J, Pedersen AM, Hayes AL, Featherstone JD (1992) Fluoride concentrations in plaque, whole saliva, and ductal saliva after application of home-use topical fluorides. J Dent Res 71:1768–1775

    Article  PubMed  Google Scholar 

  27. Zero DT (2006) Dentifrices, mouthwashes, and remineralization/caries arrestment strategies. BMC Oral Health 6(Suppl 1):S9

    Article  PubMed  Google Scholar 

  28. Thylstrup A, Bruun C, Holmen L (1994) In vivo caries models–mechanisms for caries initiation and arrestment. Adv Dent Res 8:144–157

    PubMed  Google Scholar 

  29. Reisine S, Douglass JM (1998) Psychosocial and behavioral issues in early childhood caries. Community Dent Oral Epidemiol 26:32–44

    PubMed  Google Scholar 

  30. Sayegh A, Dini EL, Holt RD, Bedi R (2005) Oral health, sociodemographic factors, dietary and oral hygiene practices in Jordanian children. J Dent 33:379–388

    Article  PubMed  Google Scholar 

  31. Santos AP, Sellos MC, Ramos ME, Soviero VM (2007) Oral hygiene frequency and presence of visible biofilm in the primary dentition. Braz Oral Res 21:64–69

    PubMed  Google Scholar 

  32. McCracken GI, Steen N, Preshaw PM, Heasman L, Stacey F, Heasman PA (2005) The crossover design to evaluate the efficacy of plaque removal in tooth-brushing studies. J Clin Periodontol 32:1157–1162

    Article  PubMed  Google Scholar 

  33. van der Weijden GA, Danser MM, Nijboer A, Timmerman MF, van der Velden U (1993) The plaque-removing efficacy of an oscillating/rotating toothbrush. A short-term study. J Clin Periodontol 20:273–278

    Article  PubMed  Google Scholar 

  34. Van der Weijden FA, Timmerman MF, Snoek IM, Reijerse E and van d, V (1996) Toothbrushing duration and plaque removing efficacy of electric toothbrushes. Am J Dent 9 Spec No:S31–S36

  35. van der Weijden GA, Timmerman MF, Reijerse E, Snoek CM, van der Velden U (1996) Toothbrushing force in relation to plaque removal. J Clin Periodontol 23:724–729

    Article  PubMed  Google Scholar 

  36. Netuschil L, Reich E, Unteregger G, Sculean A, Brecx M (1998) A pilot study of confocal laser scanning microscopy for the assessment of undisturbed dental plaque vitality and topography. Arch Oral Biol 43:277–285

    Article  PubMed  Google Scholar 

  37. Wood SR, Kirkham J, Marsh PD, Shore RC, Nattress B, Robinson C (2000) Architecture of intact natural human plaque biofilms studied by confocal laser scanning microscopy. J Dent Res 79:21–27

    Article  PubMed  Google Scholar 

  38. Liljemark WF, Bloomquist CG, Reilly BE, Bernards CJ, Townsend DW, Pennock AT, LeMoine JL (1997) Growth dynamics in a natural biofilm and its impact on oral disease management. Adv Dent Res 11:14–23

    Article  PubMed  Google Scholar 

  39. Parini MR, Pitt WG (2006) Dynamic removal of oral biofilms by bubbles. Colloids Surf B Biointerfaces 52:39–46

    Article  PubMed  Google Scholar 

  40. Kleber CJ, Putt MS, Muhler JC (1981) Duration and pattern of toothbrushing in children using a gel or paste dentifrice. J Am Dent Assoc 103:723–726

    PubMed  Google Scholar 

  41. Macgregor ID, Rugg-Gunn AJ (1985) Toothbrushing duration in 60 uninstructed young adults. Community Dent Oral Epidemiol 13:121–122

    Article  PubMed  Google Scholar 

  42. Rugg-Gunn AJ, Macgregor ID (1978) A survey of toothbrushing behaviour in children and young adults. J Periodontal Res 13:382–389

    Article  PubMed  Google Scholar 

  43. Rugg-Gunn AJ, Macgregor ID, Edgar WM, Ferguson MW (1979) Toothbrushing behaviour in relation to plaque and gingivitis in adolescent schoolchildren. J Periodontal Res 14:231–238

    Article  PubMed  Google Scholar 

  44. Saxer UP, Barbakow J, Yankell SL (1998) New studies on estimated and actual toothbrushing times and dentifrice use. J Clin Dent 9:49–51

    PubMed  Google Scholar 

  45. Emling RC, Flickinger KC, Cohen DW, Yankell SL (1981) A comparison of estimated versus actual brushing time. Pharmacol Ther Dent 6:93–98

    PubMed  Google Scholar 

  46. Nakashima K, Kurihara C, Kawanaga T et al (1989) Research into actual conditions and preventive care in periodontal disease. Relationship between questionnaire results and periodontal disease in youth. Nippon Shishubyo Gakkai Kaishi 31:1220–1241

    PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that there are no conflicts of interest in this study.

Sources of funding statement

The study was self-supported. Philips Oral Healthcare provided free Sonicare toothbrushes and GABA provided free Elmex Sensitive and ADA toothbrushes used in the study.

Author information

Authors and Affiliations

  1. Dental Clinic 1—Operative Dentistry and Periodontology, University Hospital of Erlangen, Glückstrasse 11, 91054, Erlangen, Germany

    Tonia Nagler, Imke Hopp, Anselm Petschelt & Matthias Anton Pelka

  2. Operative Dentistry and Periodontology, University Hospital of Munich, Munich, Germany

    Anna-Kristina Pelka

Authors
  1. Anna-Kristina Pelka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tonia Nagler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Imke Hopp
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anselm Petschelt
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Matthias Anton Pelka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Matthias Anton Pelka.

Additional information

Anna-Kristina Pelka, Tonia Nagler, and Imke Hopp contributed equally.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pelka, AK., Nagler, T., Hopp, I. et al. Professional brushing study comparing the effectiveness of sonic brush heads with manual toothbrushes: a single blinded, randomized clinical trial. Clin Oral Invest 15, 451–460 (2011). https://doi.org/10.1007/s00784-010-0411-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-010-0411-0

Keywords

Search

Navigation