Malabar dental college

2. Dr.Civy V Pulayath
PROFESSOR
Department of Public Health Dentistry

5. Tooth Brush

6. • Tooth brush is a hand held device with an
arrangement of bristles at one end and a
handle designed to reach effectively all
exposed surfaces of the teeth and gingiva.
• It is the most efficient mechanical teeth
cleansing device.

7. • "An ideal toothbrush may be defined as
the one which removes plaque from tooth
effectively”
• ADA has clearly stated that the method
and toothbrush choice depends on patient
oral health, manual dexterity, personal
preference, the ability and their desire to
learn and follow the prescribed
procecdures.

8. • Today, the market is flooded with various
brands of tooth brush.
• Some with more attractive packaging.
• And the others with effective advertising,
stating the size, shape, pliability, colour,
and other physical features.
• Each claiming superiority of it over the
other.

9. • Toothbrushes vary in size, design, length,
hardness, and arrangement of bristles.
• All these factors puts the consumer in
dilemma when he wants to buy a
toothbrush, as he is not aware of the
properties of different brands of tooth
brushes available in the market.
• The only practical method what they follow
is to believe what is printed in the product.

10. • But does the brands follow the guidelines
of tooth brush manufacturing ?
• Are the product informations given
scientifically correct ?
• In a dental public health point of view, this
aspect is an innovative, important and
interesting subject of research.
• Hence the present study was
contemplated with the following aim and

12. Aim
• To evaluate the claimed specifications of
30 commercially available tooth brushes
with the ADA specifications.
Objectives
• To estimate the number of rows, tufts and
bristles in the sample tooth brushes
• To measure the bristle diameter of the
sample tooth brushes
• To derive data for formulating guidelines
for toothbrush selection

16. ADA Tooth Brush Specifications
• Brushing surface should contain
Length : 25.4 - 35.8 mm
Width : 7.9 - 9.5 mm
Rows of bristles : 2 - 4
Tufts per row : 5 - 12
Bristles per tuft : 80-86

17. Diameter of commonly used bristles are :
Soft : 0.2 mm
Medium : 0.3 mm
Hard : 0.4 mm

18. Materials used
1.15 brands of toothbrushes
2.Vernier callipers
3.Traveling microscope
4.Optical flats
5.Monochromatic light source
6.Recording Form

20. 30 Commercially
Available Plain
Bristle Adult Tooth
Brushes
5 Smooth Bristle
Labeled Tooth
Brushes
5 Medium Bristle
Labeled Tooth
Brushes
5 Hard Bristle
Labeled Tooth
Brushes

21. Method used
Each toothbrush was evaluated for
1.Length of the brushing surface (Vernier
Calliper)
2.Width of the brushing surface
( Vernier Calliper)
3. No. of tufts per row (counting)
4. No. of bristles per tuft ( counting )
5.Diameter of bristles
( Optical interference method )

22. Optical Interference method

23. • Bristle kept between optically flat glass
• Illuminated with monochromatic light.
• Reflection of light in air film and production
of coherent waves.
• They interfere and produce alternate dark
and bright bands.

24. • Bristle thickness is determined by
measuring the band thickness.
• Formula used T = WL
2B
• 3 trials each done and average taken.

25. Statistical Analysis
SPSS Version 13 was used to calculate the
standard deviation

27. Tooth Brush
Brand
Length of Head Width of Head
Average mm SD Average mm SD
S1 34.17 3.464 10.4 3.512
S2 36.21 1.732 11.99 1.732
S3 46.16 4.359 13.52 2.646
S4 30.11 3.606 14.03 1.000
S5 32.13 3.000 14.03 1.000
M6 36.21 6.557 11.99 5.292
M7 47.17 3.000 14.03 2.646
M8 38.25 3.606 13.52 7.000
M9 30.09 1.000 11.99 2.000
M10 33.15 2.646 14.03 3.000
H11 36.21 1.732 11.99 5.292
H12 34.17 3.464 10.4 3.512
H13 29.07 4.359 10.94 4.726
H14 38.25 4.359 13.52 7.000
H15 37.23 7.211 14.03 1.732

28. Tooth Brush
Brand
No: of Rows No: of
Tuft/Row
No: of
Bristle/Tuft
S1 4 9 46
S2 4 10 44
S3 4 10 26
S4 3-4 12 22
S5 4 9 52
M6 3-5 7 38
M7 5 13 34
M8 4 11 82
M9 4 12 40
M10 4-5 14 36
H11 5 7 25
H12 4 9 38
H13 3-4 7 32
H14 3-4 10 21
H15 4 12 40
ADA 2-4 5-12 80-86

29. Soft Bristle Brushes
Tooth Brush
Brand
Average Diameter in mm SD
S1 0.256 0557
S2 0.159 0.718
S3 0.224 0.606
S4 0.385 0.586
S5 0.174 0.182
ADA 0.2 mm 0.356

30. Medium Bristle Brushes
Tooth Brush
Brand
Average Diameter in mm SD
M6 0.266 0.553
M7 0.179 0.718
M8 0.224 0.360
M9 0.385 0.458
M10 0.174 0.382
ADA 0.3 mm 0.556

31. Hard Bristle Brushes
Tooth Brush
Brand
Average Diameter in mm SD
H11 0.256 1.257
H12 0.159 0.718
H13 0.124 0.606
H14 0.385 0.586
H15 0.474 0.582
ADA 0.4 mm 4.556

32. Discussion

33. • The study was conducted to evaluate whether
the various tooth brushes marketed in India
fullfill the standards set by ADA.
• Certain toothbrushes marketed under "Soft"
label exhibited dimensions which were of
"Medium" toothbrushes and some "Medium" and
"Hard" brushes did not meet the set
specifications for their said categories.

34. • Few brands even failed to denote whether the
toothbrushes are of "Soft", "Medium", or "Hard"
variety.
• The greatest disparity was seen with regard to
the number of bristles per tuft. 97% of the
surveyed brushes had far less bristles than the
said specifications.

35. • The efficacy of plaque removal has been
emphasized more on the technique rather than
the type of bristles.
• Brushes with hard bristles may precipitate
adverse changes associated with brushing
resulting in abrasion of tooth surface as well as
traumatizing the gingival margin
• Hence the need of hard bristled toothbrushes in
the market is questionable.

36. • A significant number of these surveyed brushes
did not meet the ADA specifications with regard
to length and width of the head, all being larger
than the norms.
• Thus the advantages of smaller heads for
improved plaque removal especially in the
second and third molar areas are minimized with
a brush of a larger head.
• Surprisingly none of the evaluated toothbrushes
totally satisfied the specifications of ADA.

37. • The study conducted by Sasan.D(2006),
goes along with the findings of the present
study stating the need of setting up basic
guidelines for tooth brush manufacturing in
India.

38. Conclusion
Recommendations

39. • This detailed evaluation of tooth brushes
provided an insight in to the deviation from the
norm existing in the tooth brushes available in
Indian Market.
• It is important to provide guidelines to both tooth
brush manufacturers as well as the consumer to
make them aware of the specifications, its need
and importance.
• This will encourage the manufacturers to
produce quality products and consumers to
select a proper tooth brush for maintaining their
dental hygiene.

40. • Based on the study results a guidelines for tooth
brush selection can be formulated which will be
useful for the patient as well as the dentist.
• Reason for not following ADA specification may
probably due to the lack of strict quality control
on the manufacturers of tooth brushes.
• Hence professional bodies like IDA should take
initiatives to come out with set standards in
manufacturing of tooth brushes in association
with government agencies like ISI and BIS.

41. Any Questions…?

42. References

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44. Thank You