Influences of Water Jet on Brushing Force, the Number of Brushing Strokes, and Plaque Removal Effects during Manual Toothbrushing in Adults

Abstract

Toothbrushing of an individual with the use of a manual toothbrush is accompanied by manners and customs which are reflected in brushing force and the number of brushing strokes. The percent of plaque removal with a manual toothbrush is generally proportional to the product of brushing force times the number of brushing strokes, and brushing force is regulated by a feedback mechanism from the sensations of the oral mucous and periodontal membrane, and from the muscles and joints of the arm and hand which hold the toothbrush.
Therefore, the difference in individual plaque removal effects is reflected by manners and customs during toothbrushing, and the difficulty or ease of toothbrushing is reflected on the brushing areas.
Thus, it seems that other supplemental procedures are necessary besides toothbrushing with a manual toothbrush. With the use of a manual toothbrush, it would be almost impossible to hope for more effective plaque removal.
Studies were made of 13 men 22-28 years of age having a daily tooth cleaning habit with the rolling method under the following conditions: with the combined use of a manual toothbrush and water jet cleansing devices or water jet cleansing devices only.
The labial, buccal and lingual surfaces of six blocks of the dental arch were brushed for 20 seconds; measurements were made of brushing force, the number of brushing strokes and plaque removal on each surface, and the relations between brushing force and the number of brushing strokes and between plaque removal and brushing force and the number of brushing strokes were studied. The results obtained were as follows:
A. Effects of water jet on brushing force, the number of brushing strokes and plaque removal with a manual toothbrush
1. Effects of a water jet were hardly recognizable on brushing force, the number of brushing strokes and the difficulty or ease of toothbrushing being reflected on the brushing areas.
2. The examinees with a 100% plaque removal showed an indirect relationship between brushing force and the number of brushing strokes with the use of a manual toothbrush only. But such a finding was not obtained with the combined use of a manual toothbrush and a water jet.
In toothbrushing with the combined use of a toothbrush and water jet cleansing devices, the water jet was supplementally effective in plaque removal so long as the water jet was of large volume and intense force. The efficacy would be obtained on the above synergic basis.
3. It is clarified that a water jet changes the plaque removal pattern of manual toothbrushing due to the mechanical force of the water jet without relation to increased brushing force and the number of brushing strokes.
B. Plaque removal by water jet cleansing devices
1. Water jet cleansing devices were less effective than a manual toothbrush in plaque removal.
2. The greater the volume and force of the water jet, the more effective is the plaque removal on each surface of the teeth.
3. The difference among the cleansing areas in plaque removal (the difficulty or ease in removing plaque on the cleansing areas) was not observed with the use of a water jet cleansing devices.
4. Cleansing with a water jet had no relation with the feedback mechanism from the sensations of the mouth, arm and hand.