Skip to main content
Top
Published in: BMC Oral Health 1/2018

Open Access 01-12-2018 | Research article

Toothbrushing: to the best of one’s abilities is possibly not good enough

Authors: Renate Deinzer, Stefanie Ebel, Helen Blättermann, Ulrike Weik, Jutta Margraf-Stiksrud

Published in: BMC Oral Health | Issue 1/2018

Login to get access

Abstract

Background

Weaknesses in toothbrushing performance can be seen when young adults are instructed to perform habitual toothbrushing. Nothing is known about toothbrushing behavior when instructed to perform to the best abilities. The present study analyzes such behavior and compares it to habitual behavior.

Methods

A random sample of N = 98 young adults born in 1995 was examined in 2014/2015.They were asked to perform oral hygiene to the best of their abilities in front of a camera. Videos were analyzed regarding details of brushing behavior. A quality index was developed which describes the extent of the neglect of brushing on palatinal and vestibular surfaces. Data were compared to those of an earlier study of young adults (born in 1992, examined in 2011, N = 101) who were asked to perform oral hygiene as they habitually do.

Results

The 1995 cohort (best abilities) brushed their teeth significantly longer than the 1992 cohort (habitual brushing). This was due to significant longer brushing at vestibular and occlusal surfaces. Neglect of palatinal surfaces was similar in both cohorts. Groups did not differ regarding brushing movements. 40% of the brushing time on lateral surfaces was spent with scrubbing movements despite opposing advice in common oral hygiene instructions.

Conclusions

Toothbrushing to the best of one’s abilities might still not be good enough. Young adults apparently lack a reasonable concept of what is meant by high quality toothbrushing. More efforts should thus be undertaken to explain them (and adults) this concept.
Appendix
Available only for authorised users
Literature
1.
go back to reference Honkala S, Vereecken C, Niclasen B, Honkala E. Trends in toothbrushing in 20 countries/regions from 1994 to 2010. Eur J Pub Health. 2015;25(Suppl 2):20–3.CrossRef Honkala S, Vereecken C, Niclasen B, Honkala E. Trends in toothbrushing in 20 countries/regions from 1994 to 2010. Eur J Pub Health. 2015;25(Suppl 2):20–3.CrossRef
2.
go back to reference Jordan AR, Micheelis W. Fünfte Deutsche Mundgesundheitsstudie (DMS V) [Fifth German Oral Health Study]. Köln, Germany: Deutscher Zahnärzte Verlag DÄV; 2016. (Materialienreihe / Institut der Deutschen Zahnärzte; vol 35) Jordan AR, Micheelis W. Fünfte Deutsche Mundgesundheitsstudie (DMS V) [Fifth German Oral Health Study]. Köln, Germany: Deutscher Zahnärzte Verlag DÄV; 2016. (Materialienreihe / Institut der Deutschen Zahnärzte; vol 35)
3.
go back to reference Hoffmann T. Parodontalerkrankungen [Periodontal Diseases]. In: Micheelis W, Schiffner U, editors. Vierte Deutsche Mundgesundheitsstudie (DMS IV) [Fourth Oral Healh Study (DMS IV)]. Köln, Germany: Deutscher Zahnärzte Verlag DÄV; 2006. p. 266–89. (Materialienreihe / Institut der Deutschen Zahnärzte; vol. 31). Hoffmann T. Parodontalerkrankungen [Periodontal Diseases]. In: Micheelis W, Schiffner U, editors. Vierte Deutsche Mundgesundheitsstudie (DMS IV) [Fourth Oral Healh Study (DMS IV)]. Köln, Germany: Deutscher Zahnärzte Verlag DÄV; 2006. p. 266–89. (Materialienreihe / Institut der Deutschen Zahnärzte; vol. 31).
4.
go back to reference Petersen PE, Ogawa H. The global burden of periodontal disease: towards integration with chronic disease prevention and control. Periodontol. 2012;60(1):15–39.CrossRef Petersen PE, Ogawa H. The global burden of periodontal disease: towards integration with chronic disease prevention and control. Periodontol. 2012;60(1):15–39.CrossRef
5.
go back to reference Jin LJ, Lamster IB, Greenspan JS, Pitts NB, Scully C, Warnakulasuriya S. Global burden of oral diseases: emerging concepts, management and interplay with systemic health. Oral Dis. 2016;22(7):609–19.CrossRef Jin LJ, Lamster IB, Greenspan JS, Pitts NB, Scully C, Warnakulasuriya S. Global burden of oral diseases: emerging concepts, management and interplay with systemic health. Oral Dis. 2016;22(7):609–19.CrossRef
6.
go back to reference Tonetti MS, Jepsen S, Jin L, Otomo-Corgel J. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: a call for global action. J Clin Periodontol. 2017;44(5):456–62.CrossRef Tonetti MS, Jepsen S, Jin L, Otomo-Corgel J. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: a call for global action. J Clin Periodontol. 2017;44(5):456–62.CrossRef
7.
go back to reference Harnacke D, Beldoch M, Bohn G-H, Seghaoui O, Hegel N, Deinzer R. Oral and written instruction of oral hygiene: a randomized trial. J Periodontol. 2012a;83(10):1206–12.CrossRef Harnacke D, Beldoch M, Bohn G-H, Seghaoui O, Hegel N, Deinzer R. Oral and written instruction of oral hygiene: a randomized trial. J Periodontol. 2012a;83(10):1206–12.CrossRef
8.
go back to reference Harnacke D, Mitter S, Lehner M, Munzert J, Deinzer R. Improving oral hygiene skills by computer-based training: a randomized controlled comparison of the modified bass and the Fones techniques. PLoS One. 2012b;7(5):e37072.CrossRef Harnacke D, Mitter S, Lehner M, Munzert J, Deinzer R. Improving oral hygiene skills by computer-based training: a randomized controlled comparison of the modified bass and the Fones techniques. PLoS One. 2012b;7(5):e37072.CrossRef
9.
go back to reference Harnacke D, Winterfeld T, Erhardt J, Schlueter N, Ganss C, Margraf-Stiksrud J, et al. What is the best predictor for oral cleanliness after brushing? Results from an observational cohort study. J Periodontol. 2015;86(1):101–7.CrossRef Harnacke D, Winterfeld T, Erhardt J, Schlueter N, Ganss C, Margraf-Stiksrud J, et al. What is the best predictor for oral cleanliness after brushing? Results from an observational cohort study. J Periodontol. 2015;86(1):101–7.CrossRef
10.
go back to reference Harnacke D, Stein K, Stein P, Margraf-Stiksrud J, Deinzer R. Training in different brushing techniques in relation to efficacy of oral hygiene in young adults - a randomised controlled trial. J Clin Periodontol. 2016;43(1):46–52.CrossRef Harnacke D, Stein K, Stein P, Margraf-Stiksrud J, Deinzer R. Training in different brushing techniques in relation to efficacy of oral hygiene in young adults - a randomised controlled trial. J Clin Periodontol. 2016;43(1):46–52.CrossRef
11.
go back to reference Deinzer R, Jahns S, Harnacke D. Establishment of a new marginal plaque index with high sensitivity for changes in oral hygiene. J Periodontol. 2014;85(12):1730–8.CrossRef Deinzer R, Jahns S, Harnacke D. Establishment of a new marginal plaque index with high sensitivity for changes in oral hygiene. J Periodontol. 2014;85(12):1730–8.CrossRef
12.
go back to reference Deinzer R, Harnacke D, Mengel R, Telzer M, Lotzmann U, Wöstmann B. Effectiveness of computer based training (CBT) on toothbrush skills of patients treated with crowns. A randomized control trial. J Periodontol. 2016;87(11):1333–42.CrossRef Deinzer R, Harnacke D, Mengel R, Telzer M, Lotzmann U, Wöstmann B. Effectiveness of computer based training (CBT) on toothbrush skills of patients treated with crowns. A randomized control trial. J Periodontol. 2016;87(11):1333–42.CrossRef
13.
go back to reference Winterfeld T, Schlueter N, Harnacke D, Illig J, Margraf-Stiksrud J, Deinzer R, et al. Toothbrushing and flossing behaviour in young adults--a video observation. Clin Oral Investig. 2015;19(4):851–8.CrossRef Winterfeld T, Schlueter N, Harnacke D, Illig J, Margraf-Stiksrud J, Deinzer R, et al. Toothbrushing and flossing behaviour in young adults--a video observation. Clin Oral Investig. 2015;19(4):851–8.CrossRef
14.
go back to reference Ebel S, Blättermann H, Weik U, Margraf-Stiksrud J, Deinzer R. High plaque levels after thorough toothbrushing - what impedes efficacy? submitted. Ebel S, Blättermann H, Weik U, Margraf-Stiksrud J, Deinzer R. High plaque levels after thorough toothbrushing - what impedes efficacy? submitted.
15.
go back to reference Menghini GD, Steiner M, Marthaler TM, Weber RM. Rückgang der Kariesprävalenz bei Schweizer Rekruten von 1970 bis 1996 [decrease in the prevalence of caries in Swiss recruits from 1970 to 1996]. Schweiz Monatsschr Zahnmed. 2001;111:410–6.PubMed Menghini GD, Steiner M, Marthaler TM, Weber RM. Rückgang der Kariesprävalenz bei Schweizer Rekruten von 1970 bis 1996 [decrease in the prevalence of caries in Swiss recruits from 1970 to 1996]. Schweiz Monatsschr Zahnmed. 2001;111:410–6.PubMed
16.
go back to reference Stenlund H, Mejàre I, Källestål C. Caries incidence rates in Swedish adolescents and young adults with particular reference to adjacent approximal tooth surfaces: a methodological study. Community Dent Oral Epidemiol. 2003;31(5):361–7.CrossRef Stenlund H, Mejàre I, Källestål C. Caries incidence rates in Swedish adolescents and young adults with particular reference to adjacent approximal tooth surfaces: a methodological study. Community Dent Oral Epidemiol. 2003;31(5):361–7.CrossRef
17.
go back to reference Mejàre I, Stenlund H, Zelezny-Holmlund C. Caries incidence and lesion progression from adolescence to young adulthood: a prospective 15-year cohort study in Sweden. Caries Res. 2004;38(2):130–41.CrossRef Mejàre I, Stenlund H, Zelezny-Holmlund C. Caries incidence and lesion progression from adolescence to young adulthood: a prospective 15-year cohort study in Sweden. Caries Res. 2004;38(2):130–41.CrossRef
22.
go back to reference Deutsche Arbeitsgemeinschaft für Jugendzahnpflege [German working group for adolescent dental care]. Wie soll mein Kind sich die Zähne putzen. [How should my child brush his/her teeth.]; 2013 [cited 2018 Feb 12]. Available from: URL: http://www.daj.de/FAQ.17.0.html. Deutsche Arbeitsgemeinschaft für Jugendzahnpflege [German working group for adolescent dental care]. Wie soll mein Kind sich die Zähne putzen. [How should my child brush his/her teeth.]; 2013 [cited 2018 Feb 12]. Available from: URL: http://​www.​daj.​de/​FAQ.​17.​0.​html.
24.
go back to reference Muller-Bolla M, Courson F, Manière-Ezvan A, Viargues P. Toothbrushing: which methods to use? Rev Odont Stomat. 2011;40:239–60. Muller-Bolla M, Courson F, Manière-Ezvan A, Viargues P. Toothbrushing: which methods to use? Rev Odont Stomat. 2011;40:239–60.
25.
go back to reference Deinzer R, Micheelis W, Granrath N, Hoffmann T. More to learn about: periodontitis-related knowledge and its relationship with periodontal health behaviour. J Clin Periodontol. 2009;36(9):756–64.CrossRef Deinzer R, Micheelis W, Granrath N, Hoffmann T. More to learn about: periodontitis-related knowledge and its relationship with periodontal health behaviour. J Clin Periodontol. 2009;36(9):756–64.CrossRef
26.
go back to reference Deinzer R, Schmidt R, Harnacke D, Meyle J, Ziebolz D, Hoffmann T, et al. Finding an upper limit of what might be achievable by patients: oral cleanliness in dental professionals after self-performed manual oral hygiene. Clin Oral Invest. 2018;22(2):839–46.CrossRef Deinzer R, Schmidt R, Harnacke D, Meyle J, Ziebolz D, Hoffmann T, et al. Finding an upper limit of what might be achievable by patients: oral cleanliness in dental professionals after self-performed manual oral hygiene. Clin Oral Invest. 2018;22(2):839–46.CrossRef
Metadata
Title
Toothbrushing: to the best of one’s abilities is possibly not good enough
Authors
Renate Deinzer
Stefanie Ebel
Helen Blättermann
Ulrike Weik
Jutta Margraf-Stiksrud
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2018
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-018-0633-0

Other articles of this Issue 1/2018

BMC Oral Health 1/2018 Go to the issue