Toothbrushing efficacy

This thesis will explore the most meaningful aspects which are considered to be of interest regarding the efficacy of toothbrushes. One could discuss efficacy by means of plaque removal as well as by means of the effect on gingival inflammation. Plaque removal may be considered as a surrogate effect whereas effects on gingival inflammation can be considered more as an effect related to oral health. Some of the following papers in this thesis focus on instant effects such as plaque removal and may also assess gingival abrasion as a means to assess safety to soft oral tissue. The aim of this PhD research is to provide an overview on the efficacy of toothbrushing. Efficacy relates to numerous factors such as the time spend to brush, the frequency of brushing, the brushhead type, filament type and arrangement, the age of the toothbrush, and with regard to powered toothbrushes, the mode of action. Specific objectives were: 1. The toothbrush: Outdated or state of the art? 2. Effects of school-based brushing on gingivitis. 3. Toothbrush age: Is an old brush less effective as compared to a new brush? 4. Brushhead design: Is a multi-level toothbrush more effective than a flat-trimmed toothbrush. 5. Manual versus Powered. Are powered toothbrushes more effective than manual brushes? 6. Powered versus Powered. Which mode of action of powered toothbrushes is more effective? 7. Plaque removal efficacy. On average, how much plaque is removed after a single brushing episode using a powered toothbrush