Site-based plaque removal efficacy of four branded toothbrushes and the effect of dental floss in interproximal plaque removal: A randomized examiner-blind controlled study

Objectives: The aim of this study was to evaluate the sitelevel plaque removal efficacy of four commercially available toothbrushes. The adjunctive benefit of dental floss on interproximal plaque removal was also evaluated. Method and Materials: This study was designed as a randomized examiner-blinded clinical study involving 60 subjects. The subjects were randomly divided into four groups of 15 participants each, and a particular branded toothbrush was allotted for each group. Brushing technique, toothpaste, and brushing time were standardized for all the subjects. The Turesky-Gilmore-Glickman modification of Quigley-Hein plaque index was used to evaluate plaque scores at baseline, and 1, 2, 3, and 4 weeks by one blinded examiner. After 2 weeks, the subjects were provided with dental floss to be used in conjunction with the toothbrush. Buccal, lingual, and interproximal plaque reduction percentages were computed and analyzed for statistical significance. Results: The four toothbrushes showed similar plaque removal scores at the three sites, with no statistical significance (P > .05). The interproximal plaque removal scores of the four toothbrushes were the least at 2 weeks (25%) when compared with buccal (65%) and lingual (60%) percentage scores. The addition of dental floss significantly increased the interproximal plaque removal scores, with 4-week scores revealing 70% removal. Conclusion: These data revealed the lack of significance between the four toothbrushes studied, which is in line with previous studies. The addition of dental floss had a significant effect on the interproximal plaque removal, which could be crucial in the maintenance of gingival health. Keywords: dental floss, motivation, oral hygiene, plaque formation, toothbrush