Evaluation of the optimum brushing force on dental plaque removal: an in vitro study

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Patr Pujarern
Pirasut Rodanant
Eakkachai Warinsiriruk
Kanyawat Rattanasuwan


Objective: To determine an optimum brushing force for dental plaque removal on enamel surface when brushing with manual toothbrush
Material and Methods: This in vitro study used seventy-two extracted bovine incisal teeth to evaluated an efficacy of plaque removal by automate brushing machine with toothbrush (divided into positive control group, negative control group and six testing groups, each group n=9).  Streptococcus Mutans was incubated for 24 hours to formed bacterial plaque on enamel surface.  Samples were stained with erythrosine red.  Positive group was a maturation plaque stained and negative group was a plaque free sample with staining.  Brushing test was performed by automatic brushing machine under a controlled condition.  Loading force was applied from a minimum of 1 N, with an increment of 1 N to a maximum of 6 N.  Sample’s focusing area photographs were used to interpreted a remaining percentage of red color in Red Green Blue system (RGB).  Comparing mean difference by Welch’s ANOVA and Games Howell post hoc test.
Results: After testing with various brushing force, less percentage of red color remained when more force was performed. The 3 N group showed significantly less remaining red color than the positive control group but not significantly different from the negative control group (p<0.05). Less brushing force (1 N and 2 N group) showed significantly lower of remaining red color than the positive control group and significantly higher than the negative control group.
Conclusion: Brushing with 3N force was recommended for dental plaque removal from enamel surface by manual toothbrush.


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Pujarern P, Rodanant P, Warinsiriruk E, Rattanasuwan K. Evaluation of the optimum brushing force on dental plaque removal: an in vitro study. M Dent J [Internet]. 2021 Apr. 26 [cited 2023 Dec. 8];41(1):75-82. Available from: https://he02.tci-thaijo.org/index.php/mdentjournal/article/view/247466
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