2018 Volume 39 Issue 2 Pages 110-118
Tooth brushing by caregivers is important for the management of dental hygiene in infants and young children, as well as individuals with a disability or who require nursing care. However, methods used for brushing vary among caregivers depending on such factors as subject disability or developmental stage, physique, and age, as well as environment. We examined the relationship between caregiver posture and motions for tooth brushing effects including plaque removal using 20 female dental hygienists who perform caregiver brushing on a daily basis. A dental mannequin equipped with permanent dentition was placed in both the supine and face-to-face positions. The oral cavity was divided into 12 sections for each position, i.e., buccal and lingual, upper and lower, and anterior and posterior on both sides. A three-dimensional accelerometer and strain tension gauge were attached to the test toothbrush, then brushing motions and force in each position block were measured for 10 seconds. Furthermore, artificial dental plaque was applied to the artificial teeth of the mannequin prior to brushing and the area remaining after brushing was analyzed. Our results showed that brushing was performed with a vertical motion on the lingual side of the incisors and as a scrubbing method in the other regions with both postures. In the incisor regions, there was no significant difference in cycle duration between the postures, whereas three-dimensional displacement on the palatal side of the maxillary incisors was lower in the face-to-face position than in the supine position. In the molar regions, cycle duration was longer and three-dimensional displacement was lower in the face-to-face position than in the supine position, suggesting that the tooth brushing motion used in the face-to-face position had a slower rhythm. In addition, dental plaque was more likely to remain on the upper incisor palatal surfaces following brushing in the face-to-face position. Consistent caregiver posture when performing tooth brushing is difficult because of various factors, such as the body and oral condition of the subject and the brushing environment. It is important to understand the influence of posture in order to develop methods for more efficient tooth brushing by caregivers.
