Top

Clinical Oral Investigations

Published in:

01-04-2013 | Review

Brushing without brushing?—a review of the efficacy of powered toothbrushes in noncontact biofilm removal

Authors: Julia C. Schmidt, Christian Zaugg, Roland Weiger, Clemens Walter

Published in: Clinical Oral Investigations | Issue 3/2013

Abstract

Objectives

The aim of the present review was to analyze the impact of the hydrodynamic effects created by powered toothbrushes on biofilm removal in vitro.

Materials and methods

A MEDLINE search was performed for publications published by 20 May 2012; this search was complemented by a manual search. The study selection, data preparation, and validity assessment were conducted by two reviewers.

Results

Sixteen studies were included. The studies differed with respect to the methods of biofilm formation and brushing protocols. Eighteen different powered toothbrush models were evaluated. Toothbrushes with side-to-side action demonstrated biofilm removal without direct bristle contact to biofilms ranging from 38 to 99 %. Most studies found biofilm removal exceeding 50 %. Biofilm reduction using multidimensional toothbrushes was significantly lower than by those with the side-to-side mode. Detachment forces due to hydrodynamic phenomena, passing air–liquid interfaces, and acoustic energy transfer were suggested to cause reduction of the biofilm.

Conclusion

Noncontact biofilm reduction was obtained by the hydrodynamic effects of some powered toothbrushes in vitro.

Clinical relevance

Powered toothbrushes may have the potential to simplify self-performed oral hygiene. However, additional beneficial effects of higher amounts of noncontact biofilm removal in vitro have not been shown clinically, yet.

Socransky SS, Haffajee AD (2002) Dental biofilms: difficult therapeutic targets. Periodontol 28:12–55, 2000CrossRef

Axelsson P, Nystrom B, Lindhe J (2004) The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults. Results after 30 years of maintenance. J Clin Periodontol 31:749–757PubMedCrossRef

Ak G, Sepet E, Pinar A, Aren G, Turan N (2005) Reasons for early loss of primary molars. Oral Health Prev Dent 3:113–117PubMed

Slot DE, Dorfer CE, Van der Weijden GA (2008) The efficacy of interdental brushes on plaque and parameters of periodontal inflammation: a systematic review. Int J Dent Hyg 6:253–264PubMedCrossRef

Christou V, Timmerman MF, Van der Velden U, van der Weijden FA (1998) Comparison of different approaches of interdental oral hygiene: interdental brushes versus dental floss. J Periodontol 69:759–764PubMedCrossRef

Berchier CE, Slot DE, Haps S, van der Weijden GA (2008) The efficacy of dental floss in addition to a toothbrush on plaque and parameters of gingival inflammation: a systematic review. Int J Dent Hyg 6:265–279PubMedCrossRef

Rosema NA, Hennequin-Hoenderdos NL, Berchier CE, Slot DE, Lyle DM, van der Weijden GA (2011) The effect of different interdental cleaning devices on gingival bleeding. J Int Acad Periodontol 13:2–10PubMed

Hoenderdos NL, Slot DE, Paraskevas S, Van der Weijden GA (2008) The efficacy of woodsticks on plaque and gingival inflammation: a systematic review. Int J Dent Hyg 6:280–289PubMedCrossRef

Van der Weijden FA, Slot DE (2011) Oral hygiene in the prevention of periodontal diseases: the evidence. Periodontol 55:104–123, 2000CrossRef

10.

Sniehotta FF, Araujo Soares V, Dombrowski SU (2007) Randomized controlled trial of a one-minute intervention changing oral self-care behavior. J Dent Res 86:641–645PubMedCrossRef

11.

Konig J, Plagmann HC, Ruhling A, Kocher T (2002) Tooth loss and pocket probing depths in compliant periodontally treated patients: a retrospective analysis. J Clin Periodontol 29:1092–1100PubMedCrossRef

12.

Eickholz P, Kaltschmitt J, Berbig J, Reitmeir P, Pretzl B (2008) Tooth loss after active periodontal therapy. 1: patient-related factors for risk, prognosis, and quality of outcome. J Clin Periodontol 35:165–174PubMedCrossRef

13.

Matuliene G, Studer R, Lang NP, Schmidlin K, Pjetursson BE, Salvi GE, Bragger U, Zwahlen M (2010) Significance of periodontal risk assessment in the recurrence of periodontitis and tooth loss. J Clin Periodontol 37:191–199PubMedCrossRef

14.

Leung WK, Ng DK, Jin L, Corbet EF (2006) Tooth loss in treated periodontitis patients responsible for their supportive care arrangements. J Clin Periodontol 33:265–275PubMedCrossRef

15.

Emling RC, Yankell SL (1997) The application of sonic technology to oral hygiene: the third generation of powered toothbrushes. J Clin Dent 8:1–3PubMed

16.

Chilton NW, Didio A, Rothner JT (1962) Comparison of the clinical effectiveness of an electric and a standard toothbrush in normal individuals. J Am Dent Assoc 64:777–782PubMed

17.

Robinson PG, Deacon SA, Deery C, Heanue M, Walmsley AD, Worthington HV, Glenny AM, Shaw WC (2005) Manual versus powered toothbrushing for oral health. Cochrane Database Syst Rev CD002281

18.

Deacon SA, Glenny AM, Deery C, Robinson PG, Heanue M, Walmsley AD, Shaw WC (2010) Different powered toothbrushes for plaque control and gingival health. Cochrane Database Syst Rev CD004971

19.

Sharma PK, Gibcus MJ, van der Mei HC, Busscher HJ (2005) Influence of fluid shear and microbubbles on bacterial detachment from a surface. Appl Environ Microbiol 71:3668–3673PubMedCrossRef

20.

Landau LD, Lifshitz EM (1987) Fluid mechanics. Pergamon Press, Oxford

21.

Lance M, Bataille J (1991) Turbulence in the liquid phase of a uniform bubbly air–water flow. J Fluid Mech 222:95–118CrossRef

22.

Parini MR, Pitt WG (2005) Removal of oral biofilms by bubbles: the effect of bubble impingement angle and sonic waves. J Am Dent Assoc 136:1688–1693PubMed

23.

Parini MR, Eggett DL, Pitt WG (2005) Removal of Streptococcus mutans biofilm by bubbles. J Clin Periodontol 32:1151–1156PubMedCrossRef

24.

Parini MR, Pitt WG (2006) Dynamic removal of oral biofilms by bubbles. Colloids Surf B Biointerfaces 52:39–46PubMedCrossRef

25.

Busscher HJ, Jager D, Finger G, Schaefer N, van der Mei HC (2010) Energy transfer, volumetric expansion, and removal of oral biofilms by non-contact brushing. Eur J Oral Sci 118:177–182PubMedCrossRef

26.

Pitt WG (2005) Removal of oral biofilm by sonic phenomena. Am J Dent 18:345–352PubMed

27.

Adams H, Winston MT, Heersink J, Buckingham-Meyer KA, Costerton JW, Stoodley P (2002) Development of a laboratory model to assess the removal of biofilm from interproximal spaces by powered tooth brushing. Am J Dent 15 Spec No. 12B–17B

28.

Roberts FA, Hacker BM, Oswald TK, Mourad PD, McInnes C (2010) Evaluation of the use of ultrasound within a power toothbrush to dislodge oral bacteria using an in vitro Streptococcus mutans biofilm model. Am J Dent 23:65–69PubMed

29.

Schatzle M, Sener B, Schmidlin PR, Imfeld T, Attin T (2010) In vitro tooth cleaning efficacy of electric toothbrushes around brackets. Eur J Orthod 32:481–489PubMedCrossRef

30.

Mourad PD, Roberts FA, McInnes C (2007) Synergistic use of ultrasound and sonic motion for removal of dental plaque bacteria. Compend Contin Educ Dent 28:354–358PubMed

31.

Sander FM, Sander C, Toth M, Sander FG (2006) Dental care during orthodontic treatment with electric toothbrushes. J Orofac Orthop 67:337–345PubMedCrossRef

32.

van der Mei HC, Rustema-Abbing M, Bruinsma GM, de Jager M, Gottenbos B, Busscher HJ (2004) Influence of weight on removal of co-adhering bacteria from salivary pellicles by different modes of brushing. Caries Res 38:85–90PubMedCrossRef

33.

Yankell SL, Shi X, Emling RC, Bock RT (1999) Subgingival access and artificial plaque removal by a sonic cleaning device. J Clin Dent 10:139–142PubMed

34.

MacNeill S, Walters DM, Dey A, Glaros AG, Cobb CM (1998) Sonic and mechanical toothbrushes. An in vitro study showing altered microbial surface structures but lack of effect on viability. J Clin Periodontol 25:988–993PubMedCrossRef

35.

Blanco VL, Cobb CM, Williams KB, Manch-Citron JN (1997) In vitro effect of the sensonic toothbrush on treponema denticola. J Clin Periodontol 24:318–323PubMedCrossRef

36.

Yankell SL, Emling RC, Shi X (1997) Interproximal access efficacy of Sonicare plus and Braun oral-b ultra compared to a manual toothbrush. J Clin Dent 8:26–29PubMed

37.

Stanford CM, Srikantha R, Wu CD (1997) Efficacy of the Sonicare toothbrush fluid dynamic action on removal of human supragingival plaque. J Clin Dent 8:10–14PubMed

38.

Schemehorn BR, Keil JC (1995) The effect of an oscillating/rotating electric toothbrush and a sonic toothbrush on removal of stain from enamel surfaces. J Clin Dent 6:194–197PubMed

39.

Stanford CM, Srikantha R, Kirchner HL, Wu CD (2000) Removal of supragingival plaque in an intraoral model by use of the Sonicare toothbrush. J Int Acad Periodontol 2:115–119PubMed

40.

Hope CK, Wilson M (2002) Comparison of the interproximal plaque removal efficacy of two powered toothbrushes using in vitro oral biofilms. Am J Dent 15 Spec No. 7B–11B

41.

Hope CK, Petrie A, Wilson M (2003) In vitro assessment of the plaque-removing ability of hydrodynamic shear forces produced beyond the bristles by 2 electric toothbrushes. J Periodontol 74:1017–1022PubMedCrossRef

42.

Hope CK, Wilson M (2003) Effects of dynamic fluid activity from an electric toothbrush on in vitro oral biofilms. J Clin Periodontol 30:624–629PubMedCrossRef

43.

Hope CK, Petrie A, Wilson M (2005) Efficacy of removal of sucrose-supplemented interproximal plaque by electric toothbrushes in an in vitro model. Appl Environ Microbiol 71:1114–1116PubMedCrossRef

44.

Heersink J, Costerton WJ, Stoodley P (2003) Influence of the Sonicare toothbrush on the structure and thickness of laboratory grown Streptococcus mutans biofilms. Am J Dent 16:79–83PubMed

45.

Wu-Yuan CD, Anderson RD (1994) Ability of the Sonicare electronic toothbrush to generate dynamic fluid activity that removes bacteria. J Clin Dent 5:89–93

46.

Busscher HJ, Rustema-Abbing M, Bruinsma GM, de Jager M, Gottenbos B, van der Mei HC (2003) Non-contact removal of coadhering and non-coadhering bacterial pairs from pellicle surfaces by sonic brushing and de novo adhesion. Eur J Oral Sci 111:459–464PubMedCrossRef

47.

Yuen AF, Nelson R, Johnson MR, McInnes C, Nguyen HK, Sorensen JA (2004) In vitro evaluation of the efficacy and safety of the intelliclean system: interproximal biofilm removal and dentin substrate wear. Compend Contin Educ Dent 25:44–50PubMed

48.

Brambilla E, Cagetti MG, Belluomo G, Fadini L, Garcia-Godoy F (2006) Effects of sonic energy on monospecific biofilms of cariogenic microorganisms. Am J Dent 19:3–6PubMed

49.

van der Mei HC, Rustema-Abbing M, Bruinsma GM, Gottenbos B, Busscher HJ (2007) Sequence of oral bacterial co-adhesion and non-contact brushing. J Dent Res 86:421–425PubMedCrossRef

50.

Verkaik MJ, Busscher HJ, Rustema-Abbing M, Slomp AM, Abbas F, van der Mei HC (2010) Oral biofilm models for mechanical plaque removal. Clin Oral Investig 14:403–409PubMedCrossRef

51.

Hannig C, Hannig M (2009) The oral cavity—a key system to understand substratum-dependent bioadhesion on solid surfaces in man. Clin Oral Investig 13:123–139PubMedCrossRef

52.

Bos R, van der Mei HC, Busscher HJ (1999) Physical-chemistry of initial microbial adhesive interaction—its mechanisms and methods of study. FEMS Microbiol Rev 23:179–230PubMed

53.

Li J, Helmerhorst EJ, Leone CW, Troxler RF, Yaskell T, Haffajee AD, Socransky SS, Oppenheim FG (2004) Identification of early microbial colonizers in human dental biofilm. J Appl Microbiol 97:1311–1318PubMedCrossRef

54.

Kolenbrander PE, Andersen RN, Blehert DS, Egland PG, Foster JS, Palmer RJ Jr (2002) Communication among oral bacteria. Microbiol Mol Biol Rev 66:486–505, Table of contentsPubMedCrossRef

55.

Ahimou F, Semmens MJ, Haugstad G, Novak PJ (2007) Effect of protein, polysaccharide, and oxygen concentration profiles on biofilm cohesiveness. Appl Environ Microbiol 73:2905–2910PubMedCrossRef

56.

Palmer RJ Jr, Gordon SM, Cisar JO, Kolenbrander PE (2003) Coaggregation-mediated interactions of streptococci and actinomyces detected in initial human dental plaque. J Bacteriol 185:3400–3409PubMedCrossRef

57.

Paramonova E, Kalmykowa OJ, van der Mei HC, Busscher HJ, Sharma PK (2009) Impact of hydrodynamics on oral biofilm strength. J Dent Res 88:922–926PubMedCrossRef

58.

Stoodley P, Cargo R, Rupp CJ, Wilson S, Klapper I (2002) Biofilm material properties as related to shear-induced deformation and detachment phenomena. J Ind Microbiol Biotechnol 29:361–367PubMedCrossRef

59.

Lea SC, Khan A, Patanwala HS, Landini G, Walmsley AD (2007) The effects of load and toothpaste on powered toothbrush vibrations. J Dent 35:350–354PubMedCrossRef

60.

Otten MP, Busscher HJ, van der Mei HC, van Hoogmoed CG, Abbas F (2011) Acute and substantive action of antimicrobial toothpastes and mouthrinses on oral biofilm in vitro. Eur J Oral Sci 119:151–155PubMedCrossRef

61.

Williams K, Rapley K, Haun J, Walters P, Grender J, He T, Biesbrock AR (2010) Benefit of the power component of sonic and rotation-oscillation modes of action for plaque removal using power toothbrushes. Am J Dent 23:60–64PubMed

62.

Sogi SH, Subbareddy VV, Kiran SN (2002) Contamination of toothbrush at different time intervals and effectiveness of various disinfecting solutions in reducing the contamination of toothbrush. J Indian Soc Pedod Prev Dent 20:81–85PubMed

63.

Robinson PG, Damien Walmsley A, Heanue M, Deacon S, Deery C, Glenny AM, Worthington H, Shaw W (2006) Quality of trials in a systematic review of powered toothbrushes: suggestions for future clinical trials. J Periodontol 77:1944–1953PubMedCrossRef

Title: Brushing without brushing?—a review of the efficacy of powered toothbrushes in noncontact biofilm removal
Authors: Julia C. Schmidt
Christian Zaugg
Roland Weiger
Clemens Walter
Publication date: 01-04-2013
Publisher: Springer-Verlag
Published in: Clinical Oral Investigations / Issue 3/2013
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-012-0836-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Brushing without brushing?—a review of the efficacy of powered toothbrushes in noncontact biofilm removal

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

Please log in to get access to this content

Other articles of this Issue 3/2013

A retrospective study on the influence of maxillary canine impaction on premolar root morphology

Prognostic value of histamine H1 receptor expression in oral squamous cell carcinoma

Two-year clinical evaluation of composite resins in non-carious cervical lesions

Transconjunctival versus subciliary approach for orbital fracture repair—an anthropometric evaluation of 221 cases

Bond strength of self-adhesive resin cements to different treated indirect composites

Osteoblast proliferation and differentiation on a barrier membrane in combination with BMP2 and TGFβ1