Evaluation of the incidence of gingival abrasion as a result of toothbrushing

Abstract

The aims of the present study were: (1) to establish the incidence of gingival abrasion as a result of toothbrushing, using a manual and electric toothbrush; (2) to establish the influence of filament end-rounding on the incidence of gingival abrasion and the efficacy of toothbrushing; (3) to assess whether the speed of the electric brush has a feedback-effect on the brushing force used and to correlate the incidence of gingival abrasion with force. 2 experiments were carried out. In the first experiment, 50 subjects brushed for 3 weeks every other day with either a manual (Butler 411) or an electric toothbrush (Braun/Oral-B Ultra Plaque Remover-D9). All received brief instructions and were asked to abstain from oral hygiene 24 hrs before their appointment. After disclosing the teeth and gums with Mira-2-Tone solution, plaque and gingival abrasion were assessed. Next, the panelists brushed in a random split-mouth order. After brushing and a second disclosing, plaque and abrasion were re-assessed. The results showed that the incidence of gingival abrasion was comparable for the manual and the D9. Using a similar design as in experiment no. 1, in experiment no. 2 a new group of 47 subjects brushed for 3 weeks alternating between the Braun/Oral-B Plaque Remover-D7 and D9. At the appointment, the subjects first brushed in a split-mouth order with the D9 with 2 different types of endrounding. Plaque and abrasion were assessed. Immediately following this brushing exercise, the subjects re-brushed with the D7 (2800 rot/min) and the D9 (3600 rot/min) during which brushing force was measured. The results of this experiment showed that endrounding has no effect on plaque removal but does effect the incidence of gingival abrasion. Brushing force is not influenced by the speed of the brushhead and no correlation with the incidence of gingival abrasion was observed. In conclusion, the results of this study show that gingival abrasion is not influenced by brushing force, but is affected by filament endrounding.

Gingival abrasion and recession in manual and oscillating–rotating power brush users

“…In another study, with a crossover design in which panellists brushed their own teeth, the same conclusion was drawn 30. A comparable incidence of gingival abrasion for manual and power brushes was reported in a study with 50 participants who brushed for 3 weeks every other day with either a manual or power (oscillating–rotating) brush, before being assessed in a random split-mouth order 8. Another, 1-year longitudinal, study with 32 patients showed that over the long-term a power brush did not cause more abrasion than a manual brush 31.…”

“…Toothbrush grip 22, brushhead shape 23 and daily toothbrushing frequency 24 have all been thought to have an influence on gingival abrasion. It is generally accepted that stiffer filaments cause more gingival abrasion 25–27 and the need for end-rounded, rather than sharply-pointed, toothbrush filaments is well established 7,8,28. Although it is apparent that a number of factors can increase gingival abrasion, brushing force does not appear to be a factor 8 and there is even evidence that less force is used with a power brush than a manual brush 29.…”

A Bristle-Less Tooth Brush Reduces Recession Risk Over One Year Compared to a Conventional Soft Manual Brush

“…It is known that generic bristled tooth brushes can induce gingival abrasion [24], especially if the bristles are hard and not rounded [25,26]. This may occur even in those who use little force while brushing [27]. In our subjects, we asked them to return their used tooth brushes, and about 5 subjects surrendered the tooth brush they originally used prior to the study.…”

Combined effect of end-rounded versus tapered bristles and a dentifrice on plaque removal and gingival abrasion

“…The examinations were performed by a single examiner (LC), who was calibrated to assess gingival abrasion 19 and stained plaque 20 (Turesky's modification of the Quigley-Hein Plaque Index; 20 Turesky et al 21 ). The evaluation of plaque and gingival abrasion included the use of a disclosing solution.…”