Avicenna J Dent Res. 2014 June; 6(1): e21046. DOI: 10.17795/ajdr-21046 Published online 2014 June 25. Research ArticleComparison of Manual and Electric Toothbrush in Dental Plaque Removal: A Clinical TrialSeyedeh Mahsa Sheikh-Al-Eslamian 1 ; Navid Youssefi 2,* ; Seyed Ebrahim Seyed Monir 3 ; Mahdi Kadkhodazadeh 41 Department of Restorative, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran2 Private Dental Practice, Tehran, IR Iran3 Department of Periodontic, Guillan University of Medical Sciences, Rasht, IR Iran4 Department of Periodontic, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran*Corresponding author: Navid Youssefi, Private Dental Office Practice, Tehran, IR Iran. Tel.: +98-9126877622, Fax: +98-2188057531, E-mail: navid.youssefi88@gmail.com Received: June 9, 2014; Revised: June 14, 2014; Accepted: June 16, 2014Background: Mechanical oral hygiene procedures are the most effective means of plaque removal and toothbrush is the most commonly used tool for mechanical plaque removal worldwide. There is an array of available manual and electric toothbrushes in the market. Thus, choosing the best one for dental plaque removal can be of great help for patients.Objectives: This study aimed at compare the efficacy of dental plaque removal using a manual and an electric toothbrush.Materials and Methods: This experimental, single-blinded sequential clinical trial was conducted on 12 patients (ten females and two males) who aged 21 to 30 years old. The tested manual toothbrush was 35-mm soft Oral-B Pulsar and the electric one was Oral-B Professional Care 8500 DLX chargeable D18. Patients’ dental plaque score was set as zero through scaling, root planning, and polishing. Subjects were avoided tooth cleaning for three days and on day four, plaque accumulation was assessed using Tureskey's modification of Quigley and Hein plaque index.Results: The mean of plaque index was 2.13 ± 0.83 and 2.11 ± 1.01 in the manual and electric toothbrush groups, respectively. No significant difference was detected between the study toothbrushes in terms of plaque removal (P = 0.374); however, with the manual tooth brushing, plaque removal was significantly greater in the buccal than in lingual surface and in the maxilla than in the mandible (P = 0.03 and P = 0.015, respectively).Conclusions: Similar to previous studies, this study could not show the superiority of electric toothbrush over manual in plaque removal. After 72 hours, the mean of plaque index was greater in buccal than in lingual surface, which may be attributed to the natural cleansing action of the tongue.Keywords:Dental Plaque; Plaque Index; Oral HygieneCopyright © 2014, Hamadan University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.1. BackgroundPlaque-induced gingivitis is the result of an interaction between plaque microorganisms and host responses. According to the literature, more than 90% of people regardless of their age or gender are affected by plaque-induced gingivitis (1), which highlights the role of mi-crobial plaque as the main and primary cause of peri-odontal diseases. Mechanical plaque control is the most effective method for preventing periodontal disease and dental caries (1-6).Plaque control is defined as plaque removal on a rou-tine daily basis and preventing its re-accumulation on tooth surfaces (1). Dental plaque is mainly comprised of bacteria in salivary glycoprotein matrix and extracellular polysaccharides. One gram of the plaque (wet weight) contains approximately 10 11 bacteria. Plaque matrix pre-vents its removal through washing. Thus, use of mechani-cal tools is the most effective plaque removal method (1). Daily tooth brushing along with the use of other ad-juvant methods is the most reliable method for main-taining oral hygiene (1, 7). A wide array of toothbrushes is available in the market, which differs in size, design, length, hardness, and arrangement of bristles; however, an ideal toothbrush is the one that efficiently eliminates microbial plaque (8). Since the introduction of electric toothbrushes into the market, their efficacy in plaque re-moval has always been a matter of discussion and debate (9, 10). Some manufacturers claim that their products are more capable of plaque removal (1, 11). Studies have demonstrated that under controlled con-ditions and accurate supervision, well-trained individu-als were able to remove all the visible plaque; but the majorities of subjects usually fail to do so (12). The mean duration of daily-spent time for tooth cleaning is less than two minutes, which results in removal of only 4% of the accumulated plaque. Several studies have reported improved plaque removal and subsequent periodontal
