Tooth brushing effectiveness is often very low in the elderly. In order to investigate the reasons for this and examine methods of elevating brushing effectiveness, we compared young adults and the elderly with respect to various characteristics of brushing movements that affect this effectiveness in the rolling and scrubbing methods.
Especially with the rolling method, the brushing force in the elderly was not large enough to effectively cleanse the teeth. From the rotation of the brush and the muscle activity of the hand and arm during brushing, we were able to observe that the brushing was not being done properly as specified by the different brushing methods.
With the rolling method, although the brushing force was high in young adults who had high sensation thresholds of the periodontal membrane and gingiva, this force was low in the elderly, even when their thresholds were high. That is to say, the decrease in brushing force when the rolling method was used by the elderly was independent of the sensation thresholds, and therefore resulted from a deterioration in muscle force, especially in the grip. No causal relation was observed with the scrubbing method in either the elderly or young adults between brushing force and sensation thresholds of the periodontal membrane or gingiva.
The aforementioned decrease in brushing efficiency in the elderly resulting from a deterioration in muscle force could be corrected by applying a method which had been successfully used with young adults whereby they observed their brushing movements and forces recorded on an oscilloscope and, while modifying their technique, carried out repetitious practice to achieve proper brushing.
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