Effects of Bristle Hardness & Duration of Manual Tooth brushing on Plaque Control

Background: Oral health is an integral part of general health. Poor oral health can have adverse effect on general health hence a good oral health is very essential, which in turn is achieved by good oral hygiene. Even though, the concept of good oral hygiene evolved 5000 years back, it is only in the beginning of 19th century it gained more importance. (1) Dental caries and periodontal disease are the most commonly occurring diseases affecting mankind. Dental plaque is a very important factor in the causation of both the diseases. (2) Aims & Objectives: To evaluate efficacy of four different types of toothbrushes, with difference in duration of brushing along with different bristle hardness in removal of microbial plaque. Material & Methods: In a randomized controlled trial, four groups with 40 subjects used manual toothbrushes with either hard, medium, soft and ultra-soft bristles. On baseline examination, clinical parameter plaque index (Sillness & Loe, 1964) was recorded. Selected subjects were refrained from all kinds of oral hygiene measures for 24 hrs before clinical appointment. On the day of clinical appointment scores of pre and post brushing were recorded in each patient when brushing time was set for 1 minute and same procedure was repeated after a wash off period of 3 days and similar recordings were made with brushing time of 11/2minute. Primary outcome was measured with differences in the plaque index (Sillness & Loe, 1964) compared to baseline. Results: Significant reduction in mean value of plaque score was observed on comparing pre-brushing and post-brushing data in all the subjects irrespective of bristle hardness in both 1 minute and 11/2 minute groups. On increasing time duration from 1 minute to 11/2 minute intergroup comparison revealed that significant correlation exist in mean plaque score reduction in subjects using medium bristle brush, soft bristle brush, ultra-soft bristle brush. However, no significant reduction in plaque score was observed on increasing duration from 1 minute to 11/2 minute in subjects using hard bristle brush. Conclusion: Manual toothbrushes with hard bristles better remove plaque, but may also cause more soft tissue trauma compared to brushes with softer bristles