Interproximal access efficacy of three manual toothbrushes with extended, x-angled or flat multitufted bristles

This laboratory research study was conducted to evaluate three manual toothbrushes for their ability to remove artificial plaque from interproximal sites.

Interproximal access efficacy (IAE) was evaluated using a pressure-sensitive artificial plaque substrate placed around simulated anterior and posterior teeth with horizontal and vertical brushing motions. Efficacy was determined as the maximum width of artificial plaque removed from around the teeth. Testing was conducted on three manual toothbrushes with different bristle configurations coded as: Extended [Aquafresh Between Teeth (also marketed as Dr. Best Zwischenzahn)], X-angled (Oral-B CrossAction) and Flat multitufted (Oral-B Indicator). Twenty-four tests on each toothbrush design were conducted, and the results were statistically analysed using two-sample t-tests, assuming unequal variances.

The individual mean IAE values on anterior and posterior tooth shapes with vertical and horizontal brushing were significantly (P < 0.001) higher for the toothbrush with extended bristles (Aquafresh Between Teeth) than for the other two toothbrush designs tested. When the data were combined to give an overall average, the IAE for the toothbrush with extended bristles (Aquafresh Between Teeth) was significantly (P < 0.001) higher than the IAE value for the toothbrushes containing x-angled (Oral-B CrossAction) or flat multitufted bristles (Oral-B Indicator).

Based on the demonstrated predictability of the IAE assay for clinical interproximal plaque removal, the manual toothbrush with extended bristles should be an effective brush for cleansing the dental interproximal sites.