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The aim of this study was to evaluate the susceptibility of dentin to brushing abrasion using four different toothbrushes (rotating-oscillating, sonic and two types of manual toothbrushes) with the same brushing forces. Dentin samples (n = 72) were selected from 72 impacted third molars. Half of the surface of dentin samples was covered with an adhesive tape, creating a protected and a freely exposed area in the same specimen. Brushing was performed with either a: sonic (Sonicare PowerUp, Philips GmbH, Hamburg, Germany), b: oscillating-rotating (Oral B Vitality Precisions Clean, Procter & Gamble, Schwalbach am Taunus, Germany) or two different manual toothbrushes c: flat trim brush head toothbrush (Dr. Best: Original, Glaxo-Smith-Kline, Bühl, Germany) and d: rippled-shaped brush head toothbrush (Blend-a-Dent, Complete V-Interdental, Blend-a-med, Schwalbach, Germany) in a custom made automatic brushing machine. The brushing force was set to 2 N and a whitening toothpaste (RDA = 150) was used. The simulation period was performed over a calculated period to mimic a brushing behavior of two times a day brushing for eight years and six months. Dentin loss was quantitatively determined by profilometry and statistically analyzed by Wilcoxon and Mann-Whitney-U Test (p < 0.05). The mean (standard deviation) surface loss was 21.03 (±1.26) μm for the sonic toothbrush, 15.71 (±0.85) μm for the oscillating-rotating toothbrush, 6.13 (±1.24) μm for the manual toothbrush with flat trim brush head and 2.50 (±0.43) μm for the manual toothbrush with rippled-shaped brush head. Differences between all groups were statistically significant at p<0.05. Using the same brushing force and a highly abrasive toothpaste, manual toothbrushes are significantly less abrasive compared to power toothbrushes for an 8.5-year simulation.

Children with autism have heightened risk of developing oral health problems. Interventions targeting at-home oral hygiene habits may be the most effective means of improving oral hygiene outcomes in this population. This randomized control trial examined the effectiveness of a 3-week video-modeling brushing intervention delivered to patients over the internet. Eighteen children with autism were assigned to an Intervention or Control video condition. Links to videos were delivered via email twice daily. Blind clinical examiners provided plaque index ratings at baseline, midpoint, and endpoint. Results show oral hygiene improvements in both groups, with larger effect sizes in the Intervention condition. The findings provide preliminary support for the use of internet-based interventions to improve oral hygiene for children with autism.

Background Improving the oral health of elderly individuals, involving various healthcare providers, should be a key objective for multidisciplinary teams responsible for their care. We aimed to compare the effectiveness of an oral health education program based on the health action process approach (HAPA) model when provided by a dentist versus a health officer among elderly people. Methods This cluster-randomized controlled trial included elderly residents aged more than 60 years from 24 municipal neighborhood houses ( n  = 190) in Tehran, Iran, in 2021. A questionnaire was administered through face-to-face interviews at baseline to collect sociodemographic characteristics and HAPA model constructs related to toothbrushing behavior. The Simplified Oral Hygiene Index (OHI-S) was also assessed. The neighborhood houses were assigned to two groups via simple randomization: Group A, which received oral and dental health education based on the HAPA model by a dentist and an educational pamphlet ( N  = 89); and Group B, which was educated by a health officer and an educational pamphlet ( N  = 101). Both groups received reinforcement every two weeks. Follow-up oral examinations were conducted after 1 and 3 months by a blinded, calibrated examiner. The marginal model of generalized estimating equations (GEEs) with Bonferroni post hoc correction was used for intragroup and intergroup comparisons. Results The frequency of toothbrushing was not significantly different between the two groups ( p  = 0.09) after one or three months. However, the frequency of toothbrushing increased significantly in both groups ( p  < 0.001). Additionally, no difference was found in the OHI-S score between the two groups ( p  = 0.56); nevertheless, there was a statistically significant improvement in oral hygiene status in both intervention groups ( p  < 0.001). Conclusion No difference was observed in the effectiveness of educational interventions using the HAPA model when delivered by a dentist versus a health officer working in a municipal center. Both interventions were effective at promoting the oral hygiene status of elderly individuals. These interventions could be integrated into existing public health programs. Trial registration The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 7-12-2020 (registration number: IRCT20200928048868N1).

Appropriate oral hygiene is required to maintain oral health in denture wearers. This study aims to compare the role of denture cleaning methods in combination with overnight storage conditions on biofilm mass and composition on acrylic removable dentures. In a cross-over randomized controlled trial in 13 older people, 4 conditions with 2 different mechanical cleaning methods and 2 overnight storage conditions were considered: (i) brushing and immersion in water without a cleansing tablet, (ii) brushing and immersion in water with a cleansing tablet, (iii) ultrasonic cleaning and immersion in water without a cleansing tablet, and (iv) ultrasonic cleaning and immersion in water with a cleansing tablet. Each test condition was performed for 5 consecutive days, preceded by a 2-days wash-out period. Biofilm samples were taken at baseline (control) and at the end of each test period from a standardized region. Total and individual levels of selected oral bacteria (n = 20), and of Candida albicans were identified using the Polymerase Chain Reaction (PCR) technique. Denture biofilm coverage was scored using an analogue denture plaque score. Paired t-tests and Wilcoxon-signed rank tests were used to compare the test conditions. The level of significance was set at α< 5%. Overnight denture storage in water with a cleansing tablet significantly reduced the total bacterial count (p<0.01). The difference in total bacterial level between the two mechanical cleaning methods was not statistically significant. No significant effect was observed on the amount of Candida albicans nor on the analogue plaque scores. The use of cleansing tablets during overnight denture storage in addition to mechanical denture cleaning did not affect Candida albicans count, but reduced the total bacterial count on acrylic removable dentures compared to overnight storage in water. This effect was more pronounced when combined with ultrasonic cleaning compared to brushing. ClinicalTrials.gov NCT02454413.

This study aimed to investigate whether interdental brush shape influences cleaning efficacy, by comparing a waist-shaped interdental brush (W-IDB) with a cylindrical IDB (C-IDB); both provided with the same bristle texture. Cleaning efficacy of differently shaped IDBs was measured in proximal surfaces of teeth in a split-mouth cross-over design. Twenty-eight patients abolished oral hygiene for 4 d. Line angle plaque area was scanned with an intraoral camera after use of disclosing dye in baseline and after IDB application and analyzed planimetrically. Additionally, bacterial load in the IDBs was analyzed after usage by colony forming units (cfu). A Wilcoxon signed-rank test with continuity correction was used to compare the results of the waist-shaped and the cylindrically-shaped IDBs. The waist-shaped IDBs cleaned significantly better than their cylindrically-shaped counterparts (area cleaned: 23.1% vs. 18.3%), when applied at same interdental spaces (p < 0.001). However, no significant differences were found in comparison of bacterial load on the IDBs (median cfu counts: 2.3E9 vs. 2.7E9, p = 0.93). Irrespective of bristle texture or size, IDB shape have impact on cleaning efficacy. Waist-shaped IDBs are more effective in cleaning of the line angle area than cylindrically-shaped IDBs.

Aims To evaluate and compare the efficacy of manual toothbrush, audio-tactile performance (ATP) method, and musical toothbrush on plaque control and oral hygiene maintenance in visually impaired children. Methods and results The current observational study included 60 visually impaired children aged 9–16 years who were randomly divided into 3 groups, each with 20 children receiving oral hygiene instructions in different modes: Group 1 (Control) manual toothbrush, Group 2 (ATP) audio-tactile performance method with a manual toothbrush, and Group 3 musical toothbrush. Both manual (groups 1 and 2) and musical toothbrushes (Group 3) were changed after 3 months for better efficiency. Oral hygiene index simplified (OHI-S) and Rustogi Modified Navy Plaque Index (RMNPI) plaque scores were recorded at baseline, at the end of 1, 3, and 6 months. The collected data were statistically analysed using SPSS version 21. The intra- and inter-group comparisons were analysed using one-way ANOVA, and the multiple group comparisons were analysed using the Tukey HSD test. In intragroup comparisons from baseline to 6 months, both OHI-S and RMNPI plaque scores were reduced for group 3, only OHI-S plaque scores were reduced for group 2. Intergroup comparisons revealed a statistically high significant difference in OHI-S plaque scores from baseline to 6 months and RMNPI plaque scores from 1 to 6 months. Conclusion The motivation and education with musical toothbrushes and audio-tactile performance (ATP) method could aid in the improvement of oral hygiene maintenance of visually impaired children.

To assess feasibility, acceptability, and early efficacy of monetary incentive-based interventions on fostering oral hygiene in young children measured with a Bluetooth-enabled toothbrush and smartphone application. A stratified, parallel-group, three-arm individually randomized controlled pilot trial. Two Los Angeles area Early Head Start (EHS) sites. 36 parent-child dyads enrolled in an EHS home visit program for 0-3 year olds. Eligible dyads, within strata and permuted blocks, were randomized in equal allocation to one of three groups: waitlist (delayed monetary incentive) control group, fixed monetary incentive package, or lottery monetary incentive package. The intervention lasted 8 weeks. Primary outcomes were a) toothbrushing performance: mean number of Bluetooth-recorded half-day episodes per week when the child's teeth were brushed, and b) dental visit by the 2-month follow-up among children with no prior dental visit. The a priori milestone of 20% more frequent toothbrushing identified the intervention for a subsequent trial. Feasibility and acceptability measures were also assessed, including frequency of parents syncing the Bluetooth-enabled toothbrush to the smartphone application and plaque measurement from digital photographs. Digital monitoring of toothbrushing was feasible. Mean number of weekly toothbrushing episodes over 8 weeks was 3.9 in the control group, 4.1 in the fixed incentive group, and 6.0 in the lottery incentive group. The lottery group had 53% more frequent toothbrushing than the control group and 47% more frequent toothbrushing than the fixed group. Exploratory analyses showed effects concentrated among children ≤24 months. Follow-up dental visit attendance was similar across groups. iPhone 7 more reliably captured evaluable images than Photomed Cannon G16. Trial protocol and outcome measures were deemed feasible and acceptable. Results informed the study protocol for a fully powered trial of lottery incentives versus a delayed control using the smart toothbrush and remote digital incentive program administration. ClinicalTrials.gov identifier NCT03862443.

Objective Dental plaque is a major contributor to oral diseases, particularly in children, but its impact can be significantly mitigated through targeted oral health education. This study aimed to evaluate the effectiveness of various tooth-brushing instructional methods in reducing dental plaque in children. Methods A total of 120 children, aged 6 to 8, attending the pediatric department of Alborz Dental School, were randomly selected for the study. Participants were divided into four groups of 30 children each (15 boys and 15 girls). Each group received a different instructional method: (1) demonstration of tooth brushing on a dental model, (2) self-brushing in front of a mirror, (3) brushing another child’s teeth in front of a mirror, and (4) instruction via a standardized video. Dental plaque levels were measured using a disclosing agent before and after training, with a two-week follow-up to assess the impact of instruction. Senior students provided group-specific brushing training. Data were analyzed using SPSS-22 with ANOVA and t-tests, with significance set at p  < 0.05. Results All four groups demonstrated significant reductions in plaque levels post-training and at the two-week follow-up compared to baseline, as measured by the O’Leary index. The group trained with dental models showed the most substantial plaque reduction ( p  < 0.001). Conclusion Instruction using dental models proved to be the most effective and sustainable method for reducing dental plaque in children, highlighting its potential for impactful and enduring oral hygiene education.

Background The use of video teaching material is increasingly popular and has been useful under Covid-19 teaching circumstances, where practical courses have been somewhat limited according to the pandemic situation. The objective of this trial was to evaluate whether high-quality educational videos—viewed once or repeatedly—can effectively support dental students in acquiring practical skills for delivering oral hygiene instructions, while also enhancing their confidence and sense of safety. This study aims to contribute preliminary insights into the potential value of video-assisted learning in this specific context within dental education. Methods 82 students from the 2nd term of dental school were enrolled in this study and randomly assigned to two groups. The participants watched two videos showing the application of the Bass toothbrushing method and the interdental brushing technique. Group 1 viewed the video only once, whereas Group 2 viewed the videos repeatedly every week on four consecutive weeks before the seminar. By the end of the four weeks, the students participated in a practical test by blinded examiners to evaluate the level of their obtained skills of oral hygiene instructions, demonstrated on a plastic model. The data analysis was conducted by an individual who was not involved in teaching or supervising the student courses. Results The results of this trial show that the students subjectively gained confidence in performing the techniques accurately, after watching the videos. The participants exhibited significant improvement in toothbrushing technique and applying the interdental brush after repetitive viewing of the videos compared to single viewing. There were no significant differences between groups regarding the assessment of the size of interdental spaces using a colorimetric probe. Conclusion The findings of this trial support earlier studies indicating that video-based learning can serve as an effective resource for students in preclinical dental education, improving comprehension and practical skills. While enhanced technique and brush application were linked to multiple video viewings, the measurement of interdental spaces did not yield significant differences across groups.

Introduction. Oral health is considered as one of the essential components of the overall health of every individual. Maintaining oral health is a gradual process that requires commitment. Children who require special care such as hearing impairment experience difficulty in maintaining oral health primarily due to communication difficulties. This study is aimed at using different interventions to evaluate the improvement of oral hygiene in hearing impaired children. Materials and Methods. Fifty-nine children were recruited in this study that were allocated randomly into each group with twenty children as follows: group 1: pictorial, group 2: video, and group 3: control. Mean plaque and gingival scores were noted before and after the use of different interventions. Oral hygiene was categorized as “excellent,” “good,” and “fair.” Gingival health was categorized as “healthy,” “mild gingivitis,” and “moderate gingivitis.” Results. Thirty-four children (57.6%) were from 12-13 years of age bracket, and 25 (42.4%) belonged to 14-16 years of age. Regarding gender, there were 37 (62.7%) males and 22 (37.3%) females. About comparison of mean gingival and plaque scores before and after interventions in each group, a significant difference was found in group 1 (p<0.001) and group 2 (p<0.001), as compared to group 3 where the difference in scores was not significant (p>0.05). Conclusion. Maintaining oral health requires the compliance of individuals to perform different methods of preventive dentistry, such as tooth brushing and use of dental floss. The use of different oral hygiene educational interventions such as pictorial and video methods have been proven and useful for hearing impaired children in improving oral health.