ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Regular Toothbrushes are Better Than Finger Toothbrushes for the Removal of Plaque Throughout the Complete Primary Dentition
Clinical Question Is a regular toothbrush better for the removal of plaque than a finger toothbrush in children under 3 years of age?
Clinical Bottom Line The finger toothbrush is a starting point and learning tool; however, it is most effective at removing plaque on smooth surfaces and therefore a regular toothbrush is better for removing plaque throughout the primary dentition.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 17867402Galganny-Aimeida/200735 subjects, age ranged from 8-15 months old (21 males/14 females).Crossover Clinical Trial
Key resultsThe tooth wipes and the toothbrush were equally significant in reducing the plaque levels of anterior teeth (p<0.001).
#2) 1832102Cohen/199118 blind children ages 7-14 yrs and two groups of 18 sighted children as matched pairs.Case Series Study
Key resultsThe use of a tactile cleaning device (finger toothbrush) is an excellent learning tool for blind children as they build up to the use of a regular toothbrush.
#3) 15560809Graveland/200437 subjects, average age 24 yr (11 male/26 female).Randomized Split-mouth
Key resultsThe finger toothbrush removed 62% of plaque compared to the 79% removed with a manual toothbrush; therefore, the finger toothbrush is not a beneficial alternative.
Evidence Search Finger toothbrush; infant plaque removal; instruction toothbrush children
Comments on
The Evidence
Galganny-Almeida et. al., 2007 had a small patient pool of 35; however, a total of 245 anterior teeth were analyzed for plaque index scores. The author acknowledged that the study was limited to primary anterior teeth and that the evidence should not be extrapolated to the primary molars. Graveland et. al., 2004 study was of adult patients brushing their own mouths with either a finger toothbrush or a manual toothbrush. The author reviewed several studies of finger toothbrushes; however, this was not a systematic review. Graveland et. al., 2004 used the Wilcoxon-test to analyze the plaque reduction. All research was conducted at the university level. Galganny-Aimeida et. al., 2007 acknowledged the donation of the Spiffies Baby Tooth wipes; however, there were no other connections to manufacturers noted.
Applicability Based on this evidence, I would recommend that parents start with the finger toothbrush as soon as the first teeth erupt and gradually incorporate a regular toothbrush so that when the molars come in, the regular toothbrush is used exclusively.
Specialty/Discipline (Public Health) (General Dentistry) (Pediatric Dentistry)
Keywords Finger toothbrush, primary dentition, plaque removal, regular toothbrush
ID# 2496
Date of submission: 03/31/2014spacer
E-mail rosalesj@ohsu.edu
Author Jennifer Rosales
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Ronald Sakaguchi, DDS, MS, PhD, MBA and Eli Schwarz, DDS, MPH, PhD
Faculty mentor/Co-author e-mail sakaguch@ohsu.edu, schwarz@ohsu.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
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