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Toothbrushing force in relation to plaque removal

G A van der Weijden1, M F Timmerman, E Reijerse

  • 1Department of Periodontology, Academic Centre for Dentistry Amsterdam, ACTA, The Netherlands.

Journal of Clinical Periodontology
|August 1, 1996
PubMed
Summary
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Increasing brushing force improves plaque removal for both manual and electric toothbrushes. Electric toothbrushes generally remove more plaque than manual ones, except at very high forces.

Area of Science:

  • Dental hygiene
  • Biomedical engineering
  • Oral health research

Background:

  • Dental plaque accumulation is a primary factor in oral diseases.
  • Toothbrushing technique and force significantly influence plaque removal efficacy.
  • Understanding the mechanics of toothbrushing is crucial for optimizing oral hygiene practices.

Purpose of the Study:

  • To investigate the relationship between brushing force and plaque removal using manual and electric toothbrushes.
  • To compare the plaque removal efficacy of a manual toothbrush against an electric toothbrush (Braun/Oral-B Plak Control).
  • To evaluate the habitual brushing forces applied by individuals using different types of toothbrushes.

Main Methods:

  • Part 1: Controlled experiments varying brushing force (100-300g) to assess plaque removal with manual and electric toothbrushes.

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  • Part 2: A 4-way crossover study where participants used manual and three electric toothbrushes (Rotadent, Interplak, Braun) with a strain gauge to measure habitual brushing force.
  • Plaque levels were assessed using the Turesky modification of the Quigley & Hein method before and after brushing.

    • Main Results:

    • Increased brushing force led to greater plaque removal for both manual and electric toothbrushes.
    • Electric toothbrushes demonstrated superior plaque removal compared to manual toothbrushes, except at the highest force (300g).
    • Participants used significantly higher forces with manual toothbrushes (273g) compared to electric ones (Rotadent: 96g, Interplak: 119g, Braun: 146g).

    Conclusions:

    • Brushing force is a critical factor in plaque removal, with higher forces generally being more effective.
    • Electric toothbrushes are more efficient at plaque removal than manual toothbrushes under typical usage forces.
    • Habitual brushing force varies significantly between manual and electric toothbrush users, with manual users applying substantially more force.