Children in the London Boroughs of Kensington, Chelsea and Westminster have one of the highest levels of caries in England and Wales. In 1997/98, the mean dmft for 5-year-old children was 2.83 with only 45.9% of the children being caries free. The aim of this study was to determine whether teacher-supervised toothbrushing, once a day, at school, during term time, with commercial toothpaste containing 1,450 ppm fluoride, could reduce dental caries in primary school children when compared with children from the same community who did not receive this intervention. A total of 517 children (mean age 5.63 years) were recruited for the study. Class teachers were trained individually by the same dental hygienist in an appropriate toothbrushing technique for young children. Children in the intervention group brushed once a day at school. All examinations were by visual assessment only. All teeth present were assessed using the BASCD criteria. For children in the intervention group, the overall caries increment (2.60) was significantly less (10.9%; p < 0.001) than for children in the non-intervention group (2.92). Among different tooth surfaces, the difference in caries increment between the intervention group (0.78) and the non-intervention group (1.03) was greatest for the proximal surfaces (21.4%; p < 0.01). In conclusion, this study suggests that a programme of daily teacher-supervised toothbrushing with fluoride toothpaste can be effectively targeted into socially deprived communities and a significant reduction in dental caries can thereby be achieved especially among caries-susceptible children.

SummaryThe Mentadent Adaptor is a novel toothbrush developed to gently deliver excellent oral health benefits combining optimal plaque control with oral hard and soft tissue care. It has outer tufts individually mounted in an elastomer to allow flexibility under toothbrushing pressures, enabling adaptation to the surface contours of the oral cavity. These unique properties could not be measured using conventional methods and therefore, oral metrology, a new technique that enables microscopic changes in both soft and hard tissue to be quantified, was used to determine the effect of the toothbrush, in combination with toothpastes of different abrasivity, on soft and hard tissues. A further study compared the performance of the Mentadent Adaptor at maintaining gingival health with that of an internationally recognised toothbrush. It was concluded that the Mentadent Adaptor toothbrush is effective at maintaining oral health, and offers a measurable advantage over an internationally recognised toothbrush at reducing gingival bleeding and plaque accumulation. Furthermore it is potentially kinder to the hard and soft oral tissues.Toothbrushing continues to be the most widely used form of oral hygiene in developed countries. Clinical effectiveness is dependent on a number of factors, including toothbrush design, toothbrushing methods, time and frequency of brushing, the toothpaste used and the methods used to evaluate efficacy',2. Marked changes in the design of toothbrushes have occurred in the last decade. Different bristle configurations have been introduced to improve toothbrush efficiency at removing dental plaque and maintaining oral healthiz4. Changes to the design of the handle of the t o o t h b r~s h~,~ may also have contributed to improved efficacy, whilst improvements in the manufacture of the toothbrush bristles have been shown to produce less soft-tissue trauma7,*. Despite these changes and numerous studies describing and comparing the clinical benefits of different toothbrushes, according to Clayton and Addy', 'no data demonstrate unequivocally that one toothbrush is better than another'. Demonstrating significant differences between toothbrushes is difficult because of the number of factors that have to be controlled. While subjects vary considerably 0 1998 FDlMlorld Dental Press 0020-6539/98/05519-07 in toothbrushing methods and habits, and inherent rate of plaque formation, the use of a cross-over design and a defined time of abstention from physical removal of plaque can diminish these variables. The effect of different combinations of toothbrush and toothpaste is also seldom considered. For satisfactory cleaning of the teeth some degree of abrasivity of a toothpaste must be acceptedlo, although over-zealous toothbrushing can result in permanent damage to the teeth and gingival tissue1'. The gingivae then recede, leading to exposure of the root surfaces, where exposed dentine and cementum can readily be abraded by further vigorous toothbrushing12. There have been several attempts to design a toothbrush...