Gingival keratinization with hand and electric toothbrushes: a cytological comparison

Does Toothbrushing Affect Gingival Keratinization?

“…The results of the present study indicate that the increased mitotic rate and greater thickness of the gingival epithelium after toothbrushing (McHugh 1967, Hirsch et al 1967, Kapur & Shklar 1962, Bertolini 1955 are direct results of frictional stimulation of the epithelium. Friction was not found to alter the differentiation of epithelia; therefore, the more completely orthokeratinized gingival epithelium which has been found in the majority of toothbrushing studies (Derbyshire & Mankodi 1964, Simaan & Skach 1966, Robinson & Kitchen 1948, Glickman et al 1965, Hirsch et al 1967, Merzel et al 1963 appears to be a measure of the keratinizing potential of the gingival epithelium. It would seem, therefore, that a greater degree of gingival keratinization may be attained once inhibitory effects of inflammation have been reduced by the more efficient removal of dental plaque.…”

“…Several studies of the effects of increased toothbrushing have reported a clinically observed reduction in inflammation but have failed to demonstrate associated changes in the pre-existing state of gingival keratinization (Castenfelt 1952, Fraleigh 1965). Other studies have demonstrated that increased toothbrushing leads to thickening of the gingival stratum comeum (Hirsch et al 1967, Kapur & Shklar 1962, Bertolini 1955 or to parakeratinized gingival epithelia becoming more completely orthokeratinized (Merzel et al 1963, Derbyshire & Mankodi 1964, Simaan & Skach 1966, Robinson & Kitchen 1948, Glickman et al 1965, Hirsch et al 1967. The keratinized state of healthy, nonmechanically stimulated gingiva is not known because unbrushed gingiva is invariably inflamed due to the accumulation of dental plaque.…”

Comparative Frequency of Use of the Electric Toothbrush and Hand Toothbrush

“…suggesting the effectiveness of electric toothbrushes in improving the oral health of the soft tissues [1][2][3][4][5] to remove plaque and various different oral hard tissue stains and exogenous pigmentation from the teeth, [6][7][8][9][10][11][12][13] and to reduce dental calculus 14-16 when compared to a manual toothbrush. Not all reports agree concerning the superiority or effectiveness of the electric toothbrush for improving gingival health, calculus reformation or plaque removal, however, when compared to a manual brush.…”

Therapeutic Devices

“…Birch and Mumford (1963), however, found that the arcuate power-driven brush was less effective than the manual brush in removing tooth-surface debris in 60 dental students. In evaluating the keratinization of the oral epithelium, Derbyshire and Mankodi (1964) found that keratinization was increased by using the arcuate brush in 26 dental students. Fraleigh (1965) reported that the powered arcuate brush was equally effective as the manual brush on 30 patients with periodontal disease, and it was found that there was no difference in keratinization in experiments by Manhold and associates (1965) on 100 adults with marginal gingivitis, and by Bechlem and associates (1965) on 100 individuals.…”