Effects of Manual Toothbrush with Flexing Elements on Plaque Removal

Objectives: ,  This research evaluated effectiveness of a new manual toothbrush with flexing elements on plaque removal over a 5-week period relative to a negative control.  Methods: ,  This was a single-center, examiner-blinded, parallel group, randomized clinical trial.  One hundred thirty six adult volunteers with baseline pre-brushing Rustogi-Modified Navy Plaque Index (RMNPI) score of  ≥ 0.50 following 12 hours of no oral hygiene were randomized to one of two treatments: 1) new manual toothbrush with flexing elements (Oral-B Pro-Health Clinical Pro-Flex) as a test brush and 2) flat-trim manual brush (ADA manual) as a negative control. Subjects brushed with the assigned brush and a cavity protection toothpaste (Crest Cavity Protection) for 1 min, 2x day in a customary manner for 5 weeks. RMNPI assessments were conducted pre-brushing at Baseline and post-brushing at Week 5. Week 5 plaque removal scores were analyzed for treatment differences using ANCOVA with baseline RMNPI score as the covariate. Results: ,  Mean age was 40.1 years, ranging from 19 to 72, and 71% of subjects were female. Groups were balanced (p > 0.7) with respect to Baseline whole-mouth RMNPI scores, with the mean Baseline RMNPI score of 0.617 and 0.620 for the test and the negative control brush, respectively. Both products demonstrated significant (p < 0.001) reduction in Week 5 post-brushing whole-mouth RMNPI scores relative to Baseline. Use of a test toothbrush resulted in 21% greater reduction (p ≤ 0.001) in Week 5 whole-mouth RMNPI scores relative to the negative control. Additionally, use of a test toothbrush resulted in 14.6% and 34.9% greater reduction (p ≤ 0.001) in Week 5 interproximal and gingival margin RMNPI scores, respectively, relative to the negative control. Conclusions: , New manual toothbrush with flexing elements is shown to be more effective than a regular manual toothbrush in removing plaque following 5-weeks of product use.