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Statement of the Problem: Despite of many studies conducted on toothbrushes and toothpaste to find out the culprit for abrasion, there is no clear cut evidence to pin point the real cause for abrasion.
Purpose: An in vitro assessment of the role of different types of toothbrushes (soft/ medium/hard) in abrasion process when used in conjunction with...
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Objectives:
The influence of toothbrushing duration and dentifrice quantity on fluoride efficacy against dental caries is poorly understood. This study investigated effects of these two oral hygiene factors on enamel remineralisation (measured as surface microhardness recovery [SMHR]), enamel fluoride uptake (EFU), and net acid resistance (NAR) po...
Aim:
Dental caries is a multifactorial disease which has a deleterious effect on the oral cavity. Improper oral hygiene habits are a cause for the same. The aim of this study was to compare the antibacterial efficacy of Munident, an Ayurvedic (herbal) dentifrice with commercially available toothpaste.
Materials and methods:
A total of forty subj...
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... Because dental plaque is the key etiological component in the onset and progression of both caries and periodontal disease, effective plaque control is essential to maintain oral health. To remove plaque, which is a crucial component of disease prevention, the toothbrush is the most common tool used today [6]. Hence maintaining the toothbrush for effectively providing oral hygiene becomes essential. ...
Oral health is vital to overall wellness, yet toothbrushes can harbor harmful microorganisms, especially in compromised individuals. Contamination occurs when microbes survive on surfaces such as "toilet plume" where bio-aerosols are released during flushing. Therefore, it is of interest to assess the microbial contamination of toothbrushes with and without lids, stored in different environments over a period of two months. Hence, we used data from equal student groups who used toothbrushes stored inside or outside bathrooms for this study. Samples from 36 used brushes were tested for Candida albicans, Escherichia coli, Pseudomonas aeruginosa and Enterococcus faecalis using nutrient agar, MacConkey agar and biochemical tests like IMViC and TSI. Results confirmed all four pathogens across samples, with Candida identified by budding yeast appearance and Enterococcus by a negative catalase test. These findings show that toothbrush bristles support microbial survival, which can negatively impact oral and systemic health. Thus, proper storage and regular disinfection are essential to reduce infection risk so as to maintain oral hygiene.
... Moreover, chronic toothbrushing with abrasive dentifrices has been implicated as a contributory factor in gingival recession and tooth wear, although the precise mechanism by which abrasion varies with different toothbrush types and dentifrice formulations remains unclear [6]. Several in vitro studies have employed profilometric analysis to assess surface abrasivity, where a profilometer quantitatively evaluates changes in surface roughness [7]. This device functions by generating surface tracing using digital and analog systems and subsequently calculating the mean surface roughness. ...
Introduction: Toothbrushing is a primary contributor to the mechanical abrasion of enamel, and the degree of surface roughness is largely influenced by the abrasive components present in toothpaste and tooth powders. The abrasivity of dentifrices is determined by the type, composition, and particle size of the abrasive agents, which vary significantly between herbal and non-herbal formulations. The present study aimed to comparatively assess the surface roughness of enamel after brushing with herbal and non-herbal toothpastes, providing insights into their relative abrasivity and potential effects on long-term enamel wear.
Materials and methods: A total of 48 extracted premolar teeth were collected and randomly assigned into six groups. The groups included the following: Group 1 (n=8), a non-herbal toothpaste (Colgate Max Fresh, Colgate-Palmolive, New York, New York, United States); Group 2 (n=8), a non-herbal toothpaste (Pepsodent, Unilever, London, United Kingdom); Group 3 (n=8), a herbal toothpaste (Himalaya Complete Care, Himalaya Wellness Company, Karnataka, India); Group 4 (n=8), a herbal toothpaste (Dabur Meswak, Dabur India Ltd., New Delhi, India); Group 5 (n=8), a herbal tooth powder (Vicco, Vicco Labs, Maharashtra, India); and Group 6 (n=8), the control group using only distilled water. The surface roughness of the enamel in all groups was evaluated both at baseline (pre-brushing) and after a 28-day brushing regimen. Data analysis was performed using a paired t-test for intragroup comparisons and an analysis of variance (ANOVA) for intergroup comparisons to assess statistical significance.
Results: Statistical analysis demonstrated no significant differences in the surface roughness between the pre- and post-brushing measurements in any of the experimental groups. The baseline (pre-brushing) surface roughness values did not show any statistically significant variation among the groups (p=0.145), indicating initial homogeneity. However, following the 28-day brushing period, a statistically significant difference in the mean increase in surface roughness after post-brushing was observed among the groups (p=0.032), suggesting that the abrasive effects of the different dentifrices varied, leading to measurable differences in enamel roughness. Vicco tooth powder caused the highest increase in surface roughness, while Colgate Max Fresh led to the lowest increase.
Conclusion: Our study highlights that while non-herbal pastes and herbal powders exhibit differential effects on enamel roughness, all tested formulations remained within safe limits for regular use. However, the significant increase in roughness with herbal tooth powder emphasizes the need for further formulation optimization to balance efficacy and enamel safety.
... The new design of the novel ultrasound toothbrush used in this study featured multi-tufted filaments, flat-trimmed, polished end bristles arranged crisscross-style on two flexing sides. (25) Moreover in agreement with our results Kumar et al. (2015) (26) , found that flat trim end bristle designs produce less surface abrasion than alternative designs. Use of the hard bristle toothbrush with toothpaste may also be to blame for the incidence of reduced scratches or roughness by manual toothbrushes. ...
... The new design of the novel ultrasound toothbrush used in this study featured multi-tufted filaments, flat-trimmed, polished end bristles arranged crisscross-style on two flexing sides. (25) Moreover in agreement with our results Kumar et al. (2015) (26) , found that flat trim end bristle designs produce less surface abrasion than alternative designs. Use of the hard bristle toothbrush with toothpaste may also be to blame for the incidence of reduced scratches or roughness by manual toothbrushes. ...
... Following the acquisition of written informed consent and a verbal explanation regarding the use of the research, periodontally compromised upper and lower incisor teeth were extracted and collected from patients and subsequently immersed in 10% formalin solution for a duration of two weeks. A sample size of 45 teeth was calculated using G*Power software (version 3.1, University of Düsseldorf, Düsseldorf, Germany), with an effect size of 1.0, a power of 95%, and a significance level of 5% (p < 0.05) [15,16]. ...
... Bizhang et al. posited that the increased flexion of the soft-bristle toothbrush, in contrast to medium or hard-bristle toothbrushes, led to a larger contact area and a more uniform distribution of toothpaste on the dentin surface, thereby resulting in greater abrasive wear [24]. Kumar et al. previously investigated the impact of toothpaste and toothbrushes on enamel abrasion, concluding that soft-bristled toothbrushes, when used with dentifrice, resulted in greater abrasion than hard-bristled toothbrushes [15]. While nano-bristle toothbrushes offer potential benefits in reducing tooth wear, their clinical implications for non-carious cervical lesions, hypersensitivity, heavy-handed brushing, and hand-versus electronic-brush usage require further investigation. ...
Introduction: To evaluate the enamel abrasion effects of soft, ultra-soft, and nano-bristle toothbrushes using atomic force microscopy (AFM) to guide toothbrush selection for optimal enamel preservation.
Methods: This in vitro study involved 45 extracted human teeth (central and lateral incisors), randomly assigned to three groups (n=15 each): Group I (nano-bristle), Group II (ultra-soft bristle), and Group III (soft bristle). Each specimen underwent 10,000 brushing cycles with a standardized 2 N force to simulate one year of brushing. A slurry of commercially available toothpaste mixed with saline was applied, and brushing was performed with a mechanical brushing simulator. AFM analysis measured enamel surface roughness before and after brushing.
Results: Nano-bristle toothbrushes caused a minimal increase in surface roughness (mean change: 4 nm; p = 0.001), significantly less than the increases seen with soft (mean change: 14.08 nm; p = 0.001) and ultra-soft (mean change: 14.86 nm; p = 0.001) bristle toothbrushes. AFM analysis confirmed that both soft and ultra-soft bristles caused greater enamel abrasion compared to nano-bristles, with no significant difference between soft and ultra-soft bristle groups.
Conclusion: Nano-bristle toothbrushes demonstrated the least enamel abrasion in this study, suggesting they may provide a gentle alternative for preserving enamel integrity.
... 5 Studies have shown that factors such as the abrasiveness of the toothpaste, brushing technique, and frequency can influence not only the wear of dental hard tissues but also the discoloration and surface texture of composite resins. 6,7 It is important to understand how these factors interact with restorative materials like nanohybrid composites, particularly in terms of their ability to resist color changes caused by daily oral hygiene practices. ...
Aims: The objective of this study was to evaluate the color stability of five nanohybrid composite resins, including locally produced Turkish brands and an international brand, after exposure to staining and brushing simulations over time. Methods: Five nanohybrid composite resins; Filtek Z550 (FLT), Dolgunn (DLG), RubyComp Nano (CMP), Nova Compo C (NVC), and Parion (PRN) were tested. Specimens underwent staining and brushing simulations designed to replicate clinical oral conditions. The staining process involved immersing the specimens in a coffee solution for 8 hours per day over a 10-day period to simulate short-term staining (t1), and for 12 days to simulate long-term staining equivalent to 1 year (t2). Brushing cycles were used to replicate the mechanical wear caused by daily oral hygiene practices. Color measurements were recorded at baseline (t0), after 10 days of staining (t1), and after 1 year of simulated staining and brushing (t2). Additional analyses were conducted using Energy-dispersive X-ray spectroscopy (EDX) and Scanning Electron Microscopy (SEM) to investigate structural and surface characteristics. Statistical analysis was performed using generalized linear models and two-way robust ANOVA to assess the significance of differences in color stability, with a significance level set at p
... The detrimental effect of toothbrushing on the surface roughness and gloss of dental hard tissues and various restorative materials has been investigated. 9,10 Brushing wear compromises the surface properties and impairs the esthetic appearance of dental hard tissues and restorations. Studies are showing that surface roughness values higher than 0.2 μm significantly increase plaque accumulation and any change in surface roughness between 0.30-0.50 ...
Purpose: To investigate the effect of toothbrushing with new and used toothbrushes on the surface of resin composites and dental enamel.
Methods: The extracted human incisors were selected after vestibular enamel surfaces (ES) were examined. Disc-shaped specimens of direct composite (DC) and indirect composite (IC) were fabricated. Computer-aided design-computer-aided manufacturing (CAD-CAM) composite blocks (CC) were sliced in 2 mm thickness (n= 8). The surface roughness, gloss, and color were measured. The measurements were performed before and after 3 months of toothbrushing simulation (TBS) for 2,500 circular cycles. The wear index was calculated by using the ImageJ program. The specimens were subjected to an additional 2,500 cycles and the same measurements were repeated.
Results: No significant increase in surface roughness values was observed in DC, IC, and CC groups after 3 and 6 months of TBS except in the ES group. The highest change in surface gloss was observed in the DC group. Although the wear index of toothbrushes increased over time, only the increase in the IC group was statistically significant (P= 0.033).
Clinical significance: Changes in surface roughness, gloss, and discoloration of the dental enamel and restorations and wear of toothbrush bristles were increased over time.
... This study also found tooth wear to be significantly higher in individuals who used harder toothbrush bristles. Evidence shows that hard bristles have a higher potential to cause enamel abrasion and can exacerbate existing tooth erosion [26,27]. Hard-bristle toothbrushes are generally discouraged, especially for individuals at risk of enamel erosion or those with sensitive teeth and gums [28]. ...
In the past two decades, changing trends in socioeconomic status, dietary habits, and individual lifestyles of individuals have led to the emergence of tooth wear as an oral health problem. The present study aimed to investigate the prevalence and the associated etiologies of tooth wear in a convenience sample of adult patients visiting outpatient clinics of the Faculty of Dentistry at Umm Al-Qura University. This cross-sectional study was conducted on adult patients (18-40 years old) visiting outpatient clinics of the Faculty of Dentistry, Umm Al-Qura University. Two trained examiners visually assessed patients’ tooth wear using Smith and Knight’s Tooth Wear Index (TWI). Following the clinical examination, patients completed a self-administered questionnaire detailing risk factors such as the frequency of intake of acidic food and medicines, general health, chewing habits, dietary factors, and oral health-associated preventive behaviors. The resulting collected data were tabulated and statistically analyzed using Statistical Product and Service Solutions (SPSS, version 21; IBM SPSS Statistics for Windows, Armonk, NY). The total prevalence of tooth wear was 74%, and the recorded mean wear score (TWI) was 0.380 ± 0.386; anterior teeth exhibited greater wear than posterior teeth. Numerous associations were recorded between tooth wear and the tested variables in demographics, habits, diet, and medications, but most of them were not statistically significant. When toothbrushing habits were explored, the only factors to played a significant role in abrading the tooth structure were the type of brush bristles used (P-value = 0.026) and the frequency of brush renewal (P = 0.043). Patients who frequently ate citrus fruits and other acidic foods recorded high wear scores (0.509 ± 0.311 and 0.508 ± 0.402, respectively), although the difference was not statistically significant. When chewing occurred on both sides of the mouth, less tooth wear was recorded than if chewing was on the right or left side only (0.371 ± 0.260, 0.422 ± 0.273, and 0.520 ± 0.419, respectively). The study data support an association between tooth wear and patient occupation, use of hard-bristled and new toothbrushes, eating of citrus and other acidic food, and chewing on one side, as all of these factors increased the risk of tooth wear.
... In vitro methods of determining tooth surface loss (abrasion and/or erosion) have included measurements of changes in either linear or volumetric surface roughness [2,3]. Increases in surface roughness indicate increasing tooth surface loss [4,5]. ...
... With mixed abrasive/erosive lesions, surface roughness should be assessed using non-contact profilometry in assessments of roughness to mitigate misleading results on already softened enamel or dentine surfaces caused by acidic challenges [6]. However, the use of contact profilometry to assess the effects of tooth-brushing abrasion is still relevant due to the nature of bulk tissue removal caused by prolonged interaction and motion of toothbrush bristles with tooth structure, mediated by toothpaste [4]. ...
The aim of this study was to determine if SEM used with imaging software could be used to quantitatively determine the extent of dentine roughness due to tooth-brushing. Flat, polished dentine surfaces were subjected to 25,000 cycles of simulated tooth-brushing at 2 strokes per second with a load of 200g. At the end of the brushing cycle, dentine surfaces were first assessed using profilometry and then subjected to SEM analysis. Ra (average roughness) readings were obtained for profilometric assessment. Using imaging software, the horizontal distance between adjacent characteristic grooves noted on micrographs was measured, ensuring that the middle of each crest of the associated groove was used as the reference point. These two parameters were examined statistically for correlation. When Spearman Rank tests were utilized the correlation between average Ra and crest to crest measurements was 0.709 (p <0.01). A Bland Altman plot, however, showed poor agreement between the two test parameters. Further work is needed to validate the use of this methodology in the quantitative assessment of tooth surface loss due to abrasion.
... 25 According to Kumar et al., brushing technique, force, duration, and frequency must be kept constant. 13 In a similar study conducted by Yılmaz et al., the GIC samples were brushed two times/day for 2 minutes for a period of 1 week, which corresponded to 6 months of brushing in the mouth. 4 The present study aimed to increase the amount of time for which the GIC samples would be subjected to brushing. ...
... Following tooth brushing, there is an increase in Ra, promoting the formation of caries, pigment-based stains, and dental plaque. 13 Relative enamel abrasivity (REA) and RDA are two parameters frequently used to evaluate the abrasiveness of any toothpaste formulation. These parameters are normally evaluated following the method outlined by Hefferren and advised by the American Dental Association and ISO 11609. ...
... 7 In studies investigating the harmful effects of toothbrushing on the surface properties of dental hard tissues and various restorative materials, it has been stated that brushing force, technique, frequency, duration, and condition of the toothbrush and the abrasiveness of the toothpaste used are important determinants of effective plaque control and wear. 8,9 The surface deterioration caused by toothbrushing can increase plaque retention and patients are hypersensitive to roughness in the mouth. Quirynen et al. 10 revealed that the threshold value for bacterial accumulation on titanium surfaces is 0.2 µm. ...
Aim: This study aimed to determine the effects of toothbrushing force on the surface roughness, gloss, and color change of dental enamel. Material and Methods: This study was carried out on the sound vestibular enamel surfaces of 16 human permanent incisors extracted for periodontal or orthodontic reasons. Teeth were randomly divided into 2 subgroups (n=8, per group) and embedded in acrylic blocks. The vestibular enamel's initial surface roughness, gloss, and color were measured. Three measurements per sample were performed and averaged. Six months of toothbrush simulation with 5,000 circular cycles (with a load of 1.5 and 2.5 N for groups 1 and 2, respectively) (MOD Dental, Turkey) was performed. The same measurements were repeated and the data were analyzed with independent samples and paired sample t-tests (p<0.05). Results: A significant difference was observed between the surface roughness values after the toothbrushing simulation with 1.5 and 2.5 N (p=0.022). Surface gloss values decreased significantly when 1.5 and 2.5 N forces were applied (p=0.001, p=0.002, respectively). Color change (ΔE) for brushing force of 2.5 N (3.48±0.83) was statistically significantly higher than 1.5 N (2.42±0.86), (p=0.025). Conclusion: Results of this study revealed that the surface roughness and color change values increased depending on the applied brushing force whereas gloss values decreased.
