The Effect on Subgingival Inflammation and Toothbrush Wear Using The Stationary Bristle Brushing Technique.
Abstract: Hypothesis: • Using a Stationary Bristle Technique (SBT), an intrasulcular toothbrushing technique is more effective in reducing subgingival inflammation, as evidenced by bleeding on probing (BoP), than allowing people to brush their teeth the way they "normally do" without instruction, which is usually a scrub non-sulcular technique (NSBT). Aim: Primary: To compare whether a SBT is more... read moreeffective in the reduction of gingival inflammation than permitting people to brush the way they normally do without instruction. Gingival inflammation was evidenced by the percentage (%) of sites with BoP. Secondary: To determine and compare the amount of toothbrush bristle deformation at four and 12 weeks of brushing with a SBT and with a Non SBT (NSBT). Materials and Methods: Forty-eight subjects diagnosed with gingivitis were recruited. The subjects received a new toothbrush that had been photographed, and the subjects were randomly assigned to a group (N=24 per group). The first group was instructed to brush with the SBT and the other received no tooth brushing instructions. Both groups were instructed to brush twice a day for two minutes with a specific toothbrush, which was provided, and a prescribed amount of toothpaste also provided. At baseline, the mid-facial and the mid-lingual probing depths (PD), plaque and bleeding on probing (BoP) measurements of each tooth were recorded. Patients returned for evaluation at four and 12 week intervals. BoP and plaque were recorded and the subject's toothbrushes were photographed at each visit. All groups were observed for their brushing techniques and the SBT group (test) was reinstructed as needed. All technique and temporal indicators were removed from the photographs, and each toothbrush was assigned a randomized identification number. Using "ImageJ", two blind evaluators measured the bristle area of each toothbrush in order to demonstrate toothbrush bristle deformation. Results: The SBT group showed significantly greater reductions in BoP and plaque scores than the NSBT both at four (SBT=12.4% and NSBT=31.4%) and 12 weeks (SBT=11.6% and NSBT=43.8%). There was no statistically significant difference in toothbrush area among groups, although the toothbrush bristle area was greater in the NSBT group indicating greater deformation than the SBT group. Conclusions The SBT group was significantly more effective in reducing subgingival inflammation and plaque over time, compared with a non-instructed group. Over time, the toothbrushes in the NSBT group deformed more than the ones in the SBT; however, there was no statistically significant difference.
Thesis (M.S.)--Tufts University, 2016.
Submitted to the Dept. of Periodontology.
Advisor: Paul Levi.
Committee: Nathalie Jeong, Robert Gyurko, Peter Arsenault, and Matthew Finkelman.
Keywords: Dentistry, Public health education, and Public health.read less