Effect of Orthodontic Appliances on Tooth Brush Cleaning Efficiency

Objective:To quantify plaque removal with simple cross brushing and the more optimal multi-directional tooth brushing using established laboratory tooth brushing model systems. Method: Orthodontic brackets and archwire were placed on the buccal surfaces of simulated anterior and posterior dental arches. The dental arches with orthodontic treatment appliances were coated with flat, white latex ceiling paint to simulate the easy to remove dental plaque. This plaque coating covering all the buccal and proximal surfaces of both the anterior and posterior arches would be representative of the 10 hour overnight plaque accumulation. The simulated plaque covered dental arches were then brushed with either a cross-brushing or a X-Y action brushing motion at a typical manual tooth brushing rate of 16 double strokes per minute. After brushing the simulated dental arches were photographed with back and top lighting to document the residual plaque. The extent of plaque removal was measured with a Minolta Colorimeter with a 3mm diameter sensing port. Results: The orthodontic appliance and much of the buccal surface was cleared of plaque; however, the proximal and areas immediately adjacent to the orthodontic appliances were less well cleaned. Brush head load had less effect upon the degree of plaque removal than the brush head motion. Conclusion: Toothbrush instruction is important to the degree of plaque removal from various tooth sites of individuals in orthodontic treatment program. While toothbrush design may enhance tooth brushing plaque removal efficiency, the individual tooth brushing skill and compliance with a comprehensive oral hygiene program is necessary.