Toothbrush pressures of orthodontic patients

The intention of this study was to determine whether toothbrushing pressures varied significantly between groups of orthodontic patients who were good toothbrushers and those who were poor toothbrushers. Seventy-two patients undergoing full-banded orthodontic treatment were selected from the author's practice and were subjectively paired by him according to their habitual oral hygiene. One group of thirty-six patients who habitually displayed poor oral hygiene was compared to a group of thirty-six patients who habitually displayed good oral hygiene. A specially designed strain gauge with a force-averaging feedback mechanism was attached to each patient's manual toothbrush, and the force with which that patient brushed was averaged and recorded in pounds. The poor brushers averaged 0.20 pound, whereas the average pressure of the good brushers was 0.89 pound. The statistical evidence indicates that the difference between the two groups is highly significant and is unlikely to be due to chance alone. This study has shown that toothbrush pressures can be easily and accurately measured. The attempt to objectify a single characteristic of toothbrushing behavior in an orthodontic population is an effort to avoid the medical model explanation of behavior vis-a-vis the nonspecific and subjective word attitude. Future studies will determine whether poor toothbrushers can be changed into good toothbrushers through the progressive acquisition of greater toothbrushing forces.