Efficiency of Chewable Toothbrush in Reduction of Dental Plaque in Students

Rasa Mladenovic; Andrijana Cvetkovic; Brankica Martinovic; Kristina Mladenovic; Milan Zivkovic; Zoran Arsic; Sasa Mladenovic; Tanja Zecevic Lukovic; Dragana Dakovic


BMC Oral Health. 2019;19(58) 

In This Article


The ability of patients to properly and thoroughly clean the oral cavity depends to a great extent on their technique, the time of brushing, and the type of brushes used. When choosing a brush, there are a number of ergonomic elements that can influence the brush type selection. In the era of modern and 'fast' lifestyles, besides the design of the head, shape and angle of the bristles, an important ergonomic element is certainly the ease of use and availability. In this context, this study dealt with a comparative analysis of the degree of dental plaque reduction in subpopulation of students.

Comparing the 'Fuzzy Brush' brushes with conventional ones, we noticed a statistically significant difference between the upper and the lower jaw teeth surface. The 'Fuzzy Brush' brush effectively removed the plaque on the tooth surfaces in the upper jaw compared to the control brush. The values of plaque indices after toothbrushing are nevertheless high in both brushes. In support of this, no mirror was available during brushing procedure with conventional brush. Also, according to the recommendations of the chewing brush manufacturer, chewing exercise is necessary, and 2–3 uses are required for the best effect, whereas in the study we used it once. No studies were conducted on the above comparison, thus we can not compare the obtained values.

In studies published by Myoken et al.[13] and Bezgin et al.,[14] Fuzzy brush was more effective in reducing tooth plaque from oral surfaces of the teeth in children compared to a conventional brush, while in our study no statistically significant difference was observed. Our study has shown that the use of both brushes leads to a significant reduction in plaque on all dental surfaces. Although there are few studies on this topic, the obtained results of our work are fully in line with the ones conducted so far.[13–15] All this confirms the initial hypothesis that 'Fuzzy Brush' brushes can be an alternative to the use of conventional brushes, especially in situations of inability of their application. Bearing in mind that high concentration of Xylitol inhibits the growth of mutans streptococci in the dental plaque, a more extensive study is required to evaluate the impact of long-term use of the chewable brush in reduction of caries incidence.[16,17] Certain studies state that the use of chewing gum can relieve stress and depression, which is yet another attribute of the chewable brush.[18,19]

Although this study included only the student population, for ease of use, we consider that 'Fuzzy Brush Brushes' can be especially useful in the maintenance and improvement of oral health in people with special needs, in elderly with motor skills difficulties and in patients with more severe degrees of musculoskeletal system impairments. Also, chewing is a common behavior in special needs children, especially those with autism or ADHD (Attention deficit hyperactivity disorder). Children with sensory issues often feel compelled to chew on paper, clothes, or other objects. This hypothesis can be the starting point for future studies on the effectiveness of examined brushes in the preservation of oral health in children with autism or ADHD.

The use of a smartphone is growing day by day for both personal and professional purposes. They are becoming a more suitable tool for improving education in developing countries and become popular as an effective educational tool.[20–22] For the purpose of the study a questionnaire was made in the form of an application for smartphones (Dent.IN TEST App) which students completed outside the dental office. The application automatically classified students according to the oral hygiene practices, and students with poor practices were contacted for further research. This type of questionnaire is simpler, less demanding and more economical in terms of time management, and the special convenience of using a smart phone for educational purposes is to enable continuous communication and interaction between participants and examiners.[23]