Ada specification for toothbrush, bristle, dentistry, how to choose a toothbrush, ionic toothbrush, manual toothbrush, modifications of toothbrush, parts of a toothbrush, properties of an ideal toothbrush, toothbrush, types of toothbrush, ultrasonic toothbrush

1. TOOTHBRUSH
Presented By: Dhrub Mukherjee
Guided by Dr Balaji Manohar (Principal & HOD KIDS)
Department of PERIODONTICS AND IMPLANTOLOGY
KALINGA INSTITUTE OF DENTAL SCIENCES

2. CONTENTS
1. Oral Hygiene- Need for oral hygiene, Oral Hygiene Aids
2. Toothbrush
3. Evolution of toothbrush
4. Objectives of brushing
5. Properties of an ideal toothbrush
6. Parts of a toothbrush
7. Types of toothbrush
8. How to choose a toothbrush?
9. Toothbrush Care and hygiene
10. References

3. ORAL HYGIENE
Oral hygiene is the practice of keeping one's mouth clean and free of disease and other
problems by regular brushing of the teeth and cleaning between the teeth.

4. Prevents tooth decay
Prevents periodontal diseases
Prevents bad breath
Prevents plaque accumulation
Prevents staining from food and drinks
Improves systemic health
NEED FOR ORAL HYGIENE

5. ORAL HYGIENE
AIDS
TOOTHBRUSH INTERDENTAL
CLEANERS
DENTAL
FLOSS
RUBBER TIP
STIMULATORS
MOUTH
RINSERS
TONGUE
CLEANERS

6. TOOTHBRUSH
• According to the ADA council on dental
therapeutics `` the toothbrush is designed
primarily to provide cleanliness of the teeth and
oral cavity ’’.
• A toothbrush is an oral hygiene instrument used
to clean the teeth, gums, and tongue
• Tooth brushing is the act of scrubbing teeth with
a toothbrush, usually equipped with toothpaste.

7. EVOLUTION OF
TOOTHBRUSH

8. CHEW STICKS
• First evidence of
toothbrush
• (3500 B.C.E.)
Egyptians and
Babylonians

9. 1st BRISTLE
TOOTHBRUSH
15th century - Chinese took
the hairs of Siberian wild
boar and manipulated
them onto bamboo sticks,
and used it like a bristle
toothbrush

10. GREEK WAY
Europe (1500-1700)
It consisted of rubbing one’s teeth with a
linen cloth or sponge dipped in sulfhur oils
and salt solutions. Sometimes these cloths
were attached to a stick to help reach
posterior teeth.
ROMANS
Sticks with frayed ends

11. INVENTOR OF
MODERN
TOOTHBRUSH
1780, William Addis of Clerkenald,
England.
Legend has it that the idea actually
came to Addis while in prison.
Boredom proved to be the motive for
Addis to take a bone left behind from
his dinner, and bristles that he
borrowed from a guard, drilled some
holes in the bone and pucsand
combine them to create a tool to clean
his teeth.

12. 1ST PATENTED
TOOTHBRUSH
DR H.N. WADSWORTH- 1857

13. THE MODERN
TOOTHBRUSH
• William Addis - first person to mass-produce toothbrushes. The
Addis version of the toothbrush used cow tail hair drilled and
tied onto cow bones.
• 1920- Horsehairs with ivory handles
• 1937- Wallace H. Carothers created nylon in the Du Pont
laboratories.
• 1938 - Dr West’s Miracle-Tuft Toothbrush, the first nylon
toothbrush.
• World War II, Brushing teeth regularly became popular in the
United States after soldiers returned home and brought with them
their strict habits of brushing their teeth.

14. OBJECTIVES OF BRUSHING
• To clean teeth and interdental spaces of food remnants, debris, stains, etc.
• To prevent plaque formation.
• To disturb and remove plaque.
• To stimulate and massage gingival tissue.
• To clean the tongue.
• Halitosis control

15. PROPERTIES OF AN IDEAL
TOOTHBRUSH
Desirable Characteristics of a toothbrush (Wilkins 1983)
1) Conforms to individual’s requirements in size, shape and texture.

16. 2) Be easily and
efficiently manipulated.

17. 3) Be readily cleaned and
aerated, impervious to
moisture.

18. 4) Be durable and
inexpensive.

19. 5) Have prime functional
property of flexibility,
softness and diameter of
bristles or filaments and
strength, rigidity and
lightness in the handle.

20. 6) Be designed for
utility, efficiency and
cleanliness.

21. PARTS OF A
TOOTHBRUSH
HEA
D
SHAN
K
HANDLE
TUFTS
BRUSHING PLANE
Handle: it is grasped
in hand during
brushing.
Head: working end
that holds bristles or
filaments.
Tufts: clusters of
bristles secured into
head.
Brushing plane: the
surface formed by
free ends of the
bristles.
Shank: section that
connects head and
handle.

22. TYPES OF TOOTHBRUSHES
MANUA
L
POWERED ULTRASONI
C
IONIC

23. MANUAL TOOTHBRUSH
• The ideal toothbrush design is
specified as being user-friendly,
removes plaque effectively and
has no deleterious soft tissue or
hard tissue effects
• Parts- head, bristles, handles

24. ADA SPECIFICATIONS
1) Brushing surface- Length : 1-1.25 inches and 5/16-3/8 inches wide
2) Surface area : 2.54-3.2cm
3) Number of rows : 2-4 rows of bristles
4) Number of tufts : 5-12 tufts per row
5) Number of bristles : 80-85 bristles per tuft

25. HEAD
• Designed for effective cleaning of every
tooth surface
• Divided into 2 parts- toe, located at the
extreme end of the head and the heel which is
end closet to the handle
• Composed of tufts which are individual
bundles of filaments secured in a hole.
• Filaments within the tufts are known as
bristles.

26. SHAPE
• There are variety of shapes such
as rectangular, oblong, oval,
diamond shape.
• Every tooth surface can be
cleaned effectively with the
conventional toothbrush head
designs.
• Diamond shape is mostly
recommended for posterior teeth
• Round and oblong shape head is
easier to guide around brackets
and wires

27. SIZE
• There are usually three types of head size:
LARGE,MEDIUM and SMALL
• It is chosen on the basis of size of individual’s
mouth
• Generally large and medium is for adults and
small is for children
• ACCORDING TO AGE, Brush head size:
1. 0-2 years - 15mm
2. 2-6 year - 19mm
3. 6-12 years - 22mm
4. 12 years and above - 25mm

28. BRISTLE
S
• Bristles are vital because they directly contact the teeth and gum
tissue
• They usually vary in
1) texture
2) number and length of the filament
3) number of tufts
4) arrangement of tufts
5) brushing plane (same length, bilevel, multilevel, rippled or
crisscrossed with tufts angled in at least 2 different directions.)

29. BRISTLE
TYPE
Texture ranges - Very Soft , Soft , Hard.
Soft bristle toothbrush are preferred because:
• People don’t follow a proper technique of
toothbrushing
• Hard toothbrush bristles cause abrasion of the
surface .
• Gingival damage caused by hard bristles and
pull it down towards to root, which leads to
sensitivity of the teeth.

30. PATTERN
• The different bristle designs
include flat trim, multilevel,
wavy design, zigzag design etc.
• The firmness of a bristle depends
on three factors i.e. Materials,
diameter and length.

31. BRISTLE
SHAPE
• Two types: sharp edges
and end rounded
• The soft bristled brushes
are ADA approved and
end rounded type.

32. BRISTLE ARRANGEMENT
Multitufted brushes usually offer
assorted bristle sizes and shapes,
and are engineered for better
cleaning

33. ADA SPECIFICATION FOR BRISTLE
• 2-4 rows of bristles
• 5-12 tufts per row
• 80-85 bristles per tuft
Diameters of commonly used
bristles are:
• Soft = 0.007 inch (0.2 mm)
• Medium= 0.012 inch (0.3 mm)
• Hard = 0.014 inch (0.4 mm)

34. HANDLE
• Handle is that part of brush from where we
hold the brush.
• Most recent toothbrush models include
handles that are straight, curved, angled and
continued with grips and with soft rubber
areas to make them easier to hold, use and
control.
• The handle should provide a good grip to
hand.

35. PROS
Portable. It is easy to bring a manual toothbrush to the work or while travelling
Inexpensive. The average manual toothbrush in a drugstore or supermarket costs less
than $10.
Widely available. Manual toothbrushes are sold at most pharmacies or grocery
stores.
No batteries: There is no need for a power supply, nor does it cause battery waste

36. CONS
• Missing hard-to-reach spots- Interproximal
• Less effective for cleaning teeth. A 2014 review found a manual toothbrush was
less effective at removing plaque and preventing gingivitis in both the long and
short-term when compared to an electric toothbrush
• Creates excess plastic waste. Toothbrushes need to be replaced about every three
months which generates plastic waste.
• Bristles may be more abrasive than electric brushes. Difficult to judge the force
applied unlike many electric toothbrushes, where there is an alarm.
• Not ideal for certain groups. Experts say people with disabilities and the
elderly may have a difficult time brushing properly with a manual toothbrush
because of dexterity issues.

37. POWERED
TOOTHBRUSHES

38. • An electric toothbrush is a toothbrush that
makes rapid automatic bristle motions, either
back-and-forth oscillation or rotation-
oscillation (where the brush head alternates
clockwise and counterclockwise rotation), in
order to clean teeth.
• Motions at sonic speeds or below are made by
a motor.

39. HISTOR
Y
• Dr. George A. Scott – 1st powered toothbrush, but this
particular unit was actually more of electric shock
treatment rather then tooth cleansing.
• Ritsert and Binns and Grossman and Proskin found that
an electric toothbrush was more effective in removing
plaque than a manual toothbrush when used by children
and adolescents in 1950s
• 1960 – The Squibb Company introduced Broxodent, one
of the first electric toothbrushes, to the American market.
• With the introduction of the Oral-B Plaque Remover
‘D5’,1991, prophylaxis-inspired oscillating-rotating
mode of action, a major milestone in the development
timeline of power toothbrushes.

40. PART
S

41. COMMERCIAL
CLASSIFICATION
1) POWER SOURCE :
A- Disposable battery operated
B- Rechargable battery operated
2) CLEANING TECHNOLOGY MODALITIES :
Based on the movement of the head (rotating, oscillating to and fro etc)
3) BRUSH HEADS
Different designs available commercially- rectangular, oblong, oval, diamond shape

42. GENERAL INSTRUCTIONS WHILE USING POWERED
TOOTHBRUSH
• Select brush with soft, end-rounded filaments and RDA
range accepted dentifrice (<250 ADA recommended
limit).
• Patient is instructed to spread the dentifrice over
several teeth before starting to brush to prevent
splashing of the dentifrice.
• Not turning the power brush on until the brush is in

43. • The patient should vary the brush position to
reach each tooth surface, including the distal,
facial, mesial and lingual surfaces. The
angulation may need to be altered for access to
malposition teeth. Be sure to instruct the
patient to “feel” the toothbrush on all surfaces
of the teeth.

44. With power toothbrush, tongue cleaning can also be
done as it retards plaque formation and total plaque
accumulation.
1. With the tongue extruded, the brush head should be
placed at a right angle to the midline of the
tongue with the bristles pointing toward the
throat.
2. The sides of the filaments are drawn forward toward
the tip of the tongue. with light pressure.
3. This should be repeated 3-4 times till the tongue
surface is clean.

45. INDICATION
S
• Young children
• Handicapped Patients
• Individuals lacking manual dexterity
• Patients with prosthodontic or endosseous implants
• Orthodontic Patients
• Elderly dependent on care providers
• Patients on supportive periodontal therapy

46. PROS
1. There is improved patient compliance and motivation. This is mostly due to ease of
use and the novelty of using a powered brush.
2. Increased accessibility in interproximal and lingual tooth surfaces
3. Timer incorporated in certain models which standardise brushing duration
4. Safety- Safe as it is extensively researched upon, Pressure sensors which notify if too
much force is used in some toothbrushes
5. No specific brushing technique required.

47. CON
S
• COST- Much more expensive than a manual toothbrush ($30-200)
• LOUD- Louder than manual, annoying or disruptive to some
• EXCESSIVE FORCE – Abrasions and associated sensitivity if used with a
forceful hand

48. POWERED VS MANUAL

49. STUDY 1:
Powered versus manual toothbrushing for oral health 2014
Munirah Yaacob 1, Helen V Worthington, Scott A Deacon, Chris Deery, A Damien
Walmsley, Peter G Robinson, Anne-Marie Glenny
Selection criteria: Randomised controlled trials of at least four weeks of
unsupervised powered toothbrushing versus manual toothbrushing for oral health
in children and adults.
Authors' conclusions: Powered toothbrushes reduce plaque and gingivitis more
than manual toothbrushing in the short and long term.
LINK- https://pubmed.ncbi.nlm.nih.gov/24934383/

50. STUDY 2:
Comparison of Efficacy of Manual and Powered Toothbrushes in
Plaque Control and Gingival Inflammation: A Clinical Study among
the Population of East Indian Region
Prasad Kulkarni, Dhirendra Kumar Singh, and Mohamed Jalaluddin
CONCLUSION
The present study showed overall improvement in plaque and gingival
scores with powered toothbrush. This present study hence proved that
Braun/Oral-B 2D Plaque remover can be used as an alternative to manual
toothbrush and proves to be safe, superior, and effective in the
improvement of gingival health overall. However, long-term studies
should be carried out to evaluate the efficacy of these brushes on
maintenance of oral hygiene.
LINK- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5558249/

51. STUDY 3:
A single-brushing study to compare plaque removal efficacy of a new power
brush to an ADA reference manual toothbrush
Malgorzata Klukowska 1, Julie M Grender, Hans Timm
Purpose: To determine the effectiveness of a new multi-directional power
toothbrush in reducing plaque when compared to a standard manual toothbrush
control in a single brushing design.
Results: Comparing the brushes, the power brush provided a 7.9% significantly
superior mean whole mouth plaque reduction relative to the manual brush control
Both toothbrushes were well-tolerated.
LINK- https://pubmed.ncbi.nlm.nih.gov/23248893/

52. STUDY 4:
The effectiveness of manual versus powered toothbrushes for plaque removal
and gingival health: A meta-analysis
Akshay Vibhute 1, K L Vandana
Background: The aim of this systematic review and associated meta-analysis was
to compare manual and powered brushes in relation to the removal of plaque and
gingival health
Conclusion: In general there was no evidence of a statistically significant
difference between powered and manual brushes.
LINK- https://pubmed.ncbi.nlm.nih.gov/23055578/

54. ULTRASONIC TOOTHBRUSH
• An ultrasonic toothbrush is an electric
toothbrush with an implanted piezo crystal.
• The plaque destroying power of
ultrasound and the deep, gentle
cleansing wave action of sonic
vibration penetrate the gingiva
to a depth of 5 mm. This results
in the destruction of the
periodontal pathogen.
• It typically operates on a frequency of 1.6 MHz,
which translates to 96,000,000 pulses or

55. HOW DOES IT
WORK?
• Piezoelectric effect- the accumulation of electrical charge in certain solids in response to
applied mechanical stress
• The main idea in an ultrasonic toothbrush is based on the inverse piezoelectric effect where a
piezoelectric crystal resonates and mechanically deforms in the mouth cavity due to the applied
pulsed electrical field. Conversion from electrical to mechanical energy results in the
propagation of ultrasonic waves.
• Dental fluid during tooth brushing is usually a mixture of liquids (water, saliva, and liquidated
toothpaste) with entrapped air bubbles
• One of the main physical processes involved in ultrasonic cleaning is the cavitation effect, which
includes initiation, growth, oscillation, and collapse of gas bubbles, resulting in significant
mechanical forces SHEAR FORCES responsible – for permanent chemical and physical
changes on the surfaces.( Generation of heat)
• LINK- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7175112/

58. ADVANTAGE
S
• It is beneficial in destroying bacteria, removal of
stains of coffee, wine, nicotine, and food.
• It also worked under braces, cleaning, and removing
stains.
• It is gentle for children, post-surgery cases,
hypersensitive teeth cases.
• It also cleans gingival pockets where even dental
floss cannot reach

59. IS IT USEFUL
?
STUDY 1:
A clinical study comparing the supragingival plaque and gingivitis efficacy of a specially engineered
sonic powered toothbrush with unique sensing and control technologies to a commercially
available manual flat-trim toothbrush
Salim Nathoo 1, Suru Mankodi, Luis R Mateo, Patricia Chaknis, Foti Panagakos
Conclusion: The new sonic powered toothbrush a provides statistically significantly greater levels of
efficacy in the reduction of supragingival plaque, gingivitis, and gingival bleeding when compared to a
manual flat-trim toothbrush after 4 and 12 weeks of use.
LINK- https://pubmed.ncbi.nlm.nih.gov/23448083/

60. STUDY 2:
The Effectiveness of Manual versus High-Frequency, High-Amplitude Sonic Powered
Toothbrushes for Oral Health: A Meta-Analysis
M de Jager 1, A Rmaile 1, O Darch 2, J W Bikker 3
Conclusions: High-frequency, high-amplitude sonic powered toothbrushes decreased plaque and
gingivitis significantly more effectively than manual toothbrushes in everyday use in studies
lasting up to three months
LINK- https://pubmed.ncbi.nlm.nih.gov/28422461/

61. IONIC
TOOTHBRUSH
Working principle : The Principle of Polarity - Every
element in nature has a positive or negative charge.
Ionic toothbrushes work on the principle of changing
the surface charge of the tooth to repel plaque even
from the inaccessible areas of the tooth.

62. HOW DOES IT
WORK?
• An ionic toothbrush has a small titanium battery built into the handle of the
toothbrush.
• The battery connects to a titanium rod that runs throughout the toothbrush.
• A thin metal plate or band surrounds the toothbrush handle.
• Before brushing, you moisten your hands with water, and when your fingers
come in contact with the metal band, the wetness creates a closed circuit.

64. • When you brush, the charge transfers to your teeth, which
repels plaque from the tooth surface.
• Plaque has a positive charge, and the surface of teeth has a
negative charge.
• So plaque is attracted to the teeth. The toothbrush releases a
lot of positively charged ions, which change the polarity on
teeth from negative to positive.
• Now the teeth temporarily repel the plaque instead of
attracting it. The plaque are now attracted to the toothbrush
which acquires a negative charge.
• The ions neutralize acids produced by bacteria in the mouth
and remove positively charged stains from the teeth too.

66. IS IT USEFUL ?
CASE 1:
Ionic vs Manual Toothbrushes: Effect on Plaque and Oral Hygiene Status in Children
Shivangi Chandra,1 Nalini Jain,2 Rishabh Garg,3 Preeti Dhawan,4 Avantika Tuli,5 and Gyanendra
Kumar
Conclusion:
• As evident from this study, ionic toothbrush is both safe and efficient in the removal of plaque
and improving oral hygiene status.
• The plaque removing efficacy of ionic brush was shown significantly greater than conventional
manual toothbrush
• It also has potential to increase compliance with daily brushing
LINK- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229365/

67. STUDY 2 :
Clinical evaluation of an ionic tooth brush on oral hygiene
status, gingival status, and microbial parameter.
Deshmukh J , Vandana KL , Chandrashekar KT , Savitha B
CONCLUSION
• On comparison between the active ionic toothbrush and inactive ionic toothbrush over both the
study trials, there was significant difference noted in plaque removal efficiency of active ionic
toothbrush.
.
LINK- https://www.ijdr.in/article.asp?issn=0970-
9290;year=2006;volume=17;issue=2;spage=74;epage=7;aulast=Deshmukh

69. NEWER INVENTIONS IN THE
WORLD OF TOOTHBRUSHES

70. PROXABRUSH
• Specially designed brush, that can remove plaque, easily
and efficiently, from the critical surfaces which bound
residual ridges in the partially edentulous subject.
• This brush has the advantage that it carries the head of the
brush at right angles to the handle, and it is thus easy to
apply to distal and mesial surfaces of posterior teeth

71. SOLADEY
TOOTHBRUSH
• It has better plaque removing potential
than conventional toothbrushes due to a
photo-electro-chemical effect with
incorporation of an N-type
semiconductor of Titanium dioxide
(TiO) at the neck of the brush
• Photocatalytic property of the
semiconductor may be involved in some
way in the observed reduction of
plaque (By generation of free radicals)

72. LASER TOOTHBRUSH
Laser toothbrushes are an improved version of
the modern toothbrush that emits red (635 nm)
light in the visible spectrum produced by a
diode laser inside the toothbrush powered with
an AA battery.
The L.L.L.T. (low-level laser therapy) with the
help of such toothbrushes help to reduce
dentinal hypersensitivity.

73. Evaluation of the Effect of Low Level Laser Therapy Toothbrush in Treatment of Dentin
Hypersensitivity
Jaber Yaghini, 1 Ahmad Mogharehabed,2 ,* Nassimeh Safavi, 3 Mehrnush Mohamadi, 4 and Fahime
Ashtiju
CONCLUSION- The results show that both manual sensodyne toothbrush and Laser toothbrush
are efficient in dentin hypersensitivity reduction, but Laser toothbrush is more efficient than the
manual toothbrush.
LINK- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4431969/

74. SULCUS
TOOTHBRUSH
• This has a narrow head with only two rows
of bristles
• It can also be used to clean gums and teeth
in difficult or hard to reach area.

75. SUCTION TOOTHBRUSH
• This was identified by nurse managers as a
potential tool for managing daily dental
plaque build up and oral secretions during a
mouth care training session
• Yet, its effectiveness had not been
investigated in the research.

76. CBT: COLLIS CURVE (COLLIS-
CURVE INC., MINNEAPOLIS,
MINNESOTA, USA)
• It is a specially designed toothbrush
with curved bristles on the lateral
aspect of the brush head and short
straight bristle.
• This uniquely designed toothbrush
‘hugs’ the teeth to clean three tooth
surfaces and gum line all at the
same time.

77. FINGER BRUSH (I-
BRUSH)
• It uses the agility and sensitivity of the
finger. Hence it could permit a better
control over the finger pressure because the
finger can actually feel the tooth and
gingival surfaces and help positioning the
brush for more effective scrubbing
• Also recommended for infants, as there is
better control over finger pressure, and thus
there is minimum risk of injury.

78. MUSICAL
TOOTHBRUSHES
• De La Rosa suggested that an average child
removes only about 50% of the plaque
present on teeth.
• This toothbrush consists of the handle that is
available in different shapes and also when
we press the button the music will play for 2-
3 min.
• When music starts, the child will start the
brushing when the music stop the child will
stop the brushing.

79. CHEWABLE
TOOTHBRUSH
• A chewable toothbrush is a miniature plastic
moulded toothbrush which can be placed
inside the mouth.
• The device includes a chewable bristle
holder with bristles attached to the holder, a
cavity formed within the holder, a substance
within the cavity, and regions of weakness
formed in the holder that prevent leakage of
the contents of the holder until the device is
compressed by chewing

80. Efficiency of chewable toothbrush in reduction of dental plaque in students
Rasa Mladenovic, Andrijana Cvetkovic, Brankica Martinovic, Kristina Mladenovic, Milan
Zivkovic, Zoran Arsic, Sasa Mladenovic, Tanja Zecevic Lukovic & Dragana Dakovic
Method: Respondents are divided into two groups: control group used conventional toothbrushes,
respondents from the tested group used chewable toothbrush.
Conclusion:
Both types of brushes are effective in removing dental plaque. The fact that there is no significant
difference in the effectiveness of the tested brushes indicates the benefits of using ‘Fuzzy brush’
brushes in order to reduce plaque, primarily in the inability to use conventional brushes.
LINK- https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-019-0748-y

81. END-TUFTED
TOOTHBRUSH
• Used as a ‘broom that would sweep the
occlusal surface from inside out’, i.e. from
the centre of tooth towards to buccal and
lingual surfaces.
• Studies showed that end-tufted toothbrush
was very effective in occlusal plaque
removal in erupting mandibular first
permanent molars.

82. DOUBLE HEADED
TOOTHBRUSH
• According to certain
studies, this design
of toothbrush was
more effective in
plaque removal in
adults.
• Dimensions : 14 mm
long, 10 mm wide,
contained 20 tufts
with 90 bristles
each of length 8 mm
and diameter 0.15

83. SPECIALITY TOOTHBRUSHES
Orthodontic
Toothbrush
• The orthodontic toothbrush has
been developed for safe and
effective brushing of teeth
fitted with orthodontic
appliances including braces,
brackets, tubes and wires.

84. POST-SURGICAL
TOOTHBRUSH
• These toothbrushes are kept with 1
goal in mind – to keep the healing
wound clean.
• The post-surgical toothbrush is highly
effective in removing plaque and food
debris near the wound and sutures

85. DENTURE TOOTHBRUSH
• The Denture brush consists of two differently
configured brush heads: a flat bristled head for
smooth surfaces and a single-tufted head for
hard to-reach areas.
• It is recommended that removable dentures and
orthodontic retainers are brushed at least twice a
day, especially after meals.

86. HOW TO CHOOSE A
TOOTHBRUSH?
• No of scientific evidence exists yet to show that any one type
of toothbrush design is better at removing plaque than another.
ADA recommends
• Toothbrush head should be small (1" by 1/2") for easy access to
all areas of the mouth, teeth and gums.
• It should have a long, wide handle for a firm grasp.
• It should have soft nylon bristles with rounded ends so you
won't hurt your gums.
• Toothbrushes should be changed every three to four months or
when it starts to show some wear, whichever comes first.

87. TOOTHBRUSH CARE AND
HYGIENE
CDC Recommends:
• Do not share toothbrushes. Toothbrushes can have germs on them even after rinsing that could raise the risk
of infection, especially for people with immune suppression.
• After brushing, rinse your toothbrush with tap water until it is completely clean, let it air-dry, and store it in
an upright position. If more than one brush is stored in the same holder, do not let them touch each other.
• You do not need to soak toothbrushes in disinfecting solutions or mouthwash, which may actually spread
germs under the right conditions.
• You do not need to use dishwashers, microwaves, or ultraviolet devices to disinfect toothbrushes. These
methods may damage the toothbrush.
• Avoid covering toothbrushes or storing them in closed containers, which can cause the growth of bacteria.
• Replace your toothbrush every 3 to 4 months, or sooner if the bristles look worn out.

88. REFERENC
ES
• Dr Stephen Hudis, ‘ the evolution of toothbrush’, blog in the Princeton restorative
and implant dentistry
• Hygiene Tribune Vol. 4, No. 3, 2011
• Toothbrush, its design and modifications : An Overview- Silky Mehta, C.V. Sruthi
Vyaasini, Lucky Jindal, Vishnu Sharma, Talika Jasuja
• Powered versus manual toothbrushing for oral health - Munirah Yaacob 1, Helen V
Worthington, Scott A Deacon, Chris Deery, A Damien Walmsley, Peter G
Robinson, Anne-Marie Glenny
• Manual vs. electric toothbrushes: Which is better for your teeth, according to
dentists - Michael B. Ferguson, Shaena Montanari .
• Essentials of Public Health Dentistry- Soben Peter
• Newman and Carranza’s clinical periodontology
• The effectiveness of manual versus powered toothbrushes for plaque removal and
gingival health: A meta-analysis - Akshay Vibhute 1, K L Vandana
• cdc.gov- Use & Handling of Toothbrushes
• Ionic Toothbrushes – what are they and how do they work? Hutto-hippo family
dental
• How Electric Toothbrush Work – ‘Useless Mod’ – YouTube
• Comparison of Efficacy of Manual and Powered Toothbrushes in Plaque Control and
Gingival Inflammation: A Clinical Study among the Population of East Indian Region -
Prasad Kulkarni, Dhirendra Kumar Singh, and Mohamed Jalaluddin

89. • A clinical study comparing the supragingival plaque and gingivitis
efficacy of a specially engineered sonic powered toothbrush with unique
sensing and control technologies to a commercially available manual
flat-trim toothbrush Salim Nathoo 1, Suru Mankodi, Luis R
Mateo, Patricia Chaknis, Foti Panagakos
• Deshmukh J , Vandana KL , Chandrashekar KT , Savitha B. Clinical
evaluation of an ionic tooth brush on oral hygiene status, gingival
status, and microbial parameter.
• Evaluation of the Effect of Low Level Laser Therapy Toothbrush in
Treatment of Dentin Hypersensitivity Jaber Yaghini, 1 Ahmad
Mogharehabed, 2 ,Nassimeh Safavi, 3 Mehrnush Mohamadi, 4 and Fahime
Ashtiju
• New Dimensions in Mechanical Plaque Control: An Overview-Arnab Mandal, Dhirendra Kumar Singh,
Humaira Siddiqui, Diptajit Das1 Arka Kanti Dey2
• The Effectiveness of Manual versus High-Frequency, High-Amplitude Sonic Powered Toothbrushes
for Oral Health: A Meta-Analysis- M de Jager 1, A Rmaile 1, O Darch 2, J W Bikker
• Ionic vs Manual Toothbrushes: Effect on Plaque and Oral Hygiene Status in Children - Shivangi
Chandra,1 Nalini Jain,2 Rishabh Garg, 3 Preeti Dhawan,4 Avantika Tuli,5 and Gyanendra Kumar