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Interdental biofilm reduction and composition after use of an activated and inactivated side-to-side toothbrush — a proof-of-principle clinical study

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Abstract

Objectives

To evaluate interdental biofilm reduction and composition after powered toothbrushing with a side-to-side (sonic) toothbrush compared to manual toothbrushing following single brushing exercises in periodontally healthy young adults.

Materials and methods

All participants brushed with a side-to-side toothbrush without toothpaste in four different modes: toothbrush (a) inactivated without instruction (OFF-NI), (b) activated without instruction (ON-NI), (c) inactivated with instruction (OFF-I), and (d) activated with instruction (ON-I) at consecutive visits (single brushing exercises). Before and after brushing, the Approximal Plaque Index (API) was assessed at three interdental spaces and plaque samples were taken from two interdental sites. Biofilm reduction and composition were analyzed microbiologically by total bacterial load and 16S rRNA sequencing.

Results

Thirty participants (age: 22.9 ± 2.5 years) completed the study. Most participants showed no or incomplete plaque removal assessed by API following single brushing exercises, while the frequency of API reduction was higher after ON-NI compared to OFF-I (p = 0.023). Irrespective of the brushing mode, a significant reduction of total bacterial load was detected with lower bacterial counts after OFF-NI compared to ON-NI (p = 0.008) and ON-I (p = 0.007). Biofilm composition showed slight changes in the relative abundances of bacterial taxa, regardless of the brushing mode.

Conclusions

Manual and powered toothbrushing with a side-to-side toothbrush, with and without instruction, showed incomplete interdental biofilm removal in periodontally healthy young adults following single brushing exercises.

Clinical relevance

Data has to be validated in further studies on other groups, however, in periodontally healthy young adults, additional devices seem to be necessary for sufficient interdental cleaning.

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Acknowledgements

The authors express their special thanks to Microsynth AG (Balgach, Switzerland) for the microbiological analyses.

Funding

The study was funded by the Medical Faculty of the University of Freiburg and the Medical Faculty of the University of Giessen. This part of the project was supported in part by an unrestricted grant from the Swiss Society of Dentistry (SSO), project number 304–18.

Author information

Authors and Affiliations

  1. Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine Basel (UZB), University of Basel, Mattenstrasse 40, 4058, Basel, Switzerland

    Julia C. Difloe-Geisert

  2. Division for Cariology, Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Medical Center University of Freiburg, University of Freiburg, Freiburg, Germany

    Sarah Fiedler & Nadine Schlueter

  3. Department Research, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland

    Eva M. Kulik

  4. Department of Conservative and Preventive Dentistry, Dental Clinic, Justus Liebig University, Giessen, Germany

    Carolina Ganss

  5. Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany

    Clemens Walter

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  1. Julia C. Difloe-Geisert
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Contributions

Conceptualization: Carolina Ganss, Nadine Schlueter, Clemens Walter.

Methodology: Julia C. Difloe-Geisert, Carolina Ganss, Eva M. Kulik, Nadine Schlueter, Clemens Walter.

Formal analysis and investigation: Julia C. Difloe-Geisert, Sarah Fiedler, Eva M. Kulik, Clemens Walter.

Writing—original draft preparation: Julia C. Difloe-Geisert, Clemens Walter.

Writing—review and editing: Julia C. Difloe-Geisert, Sarah Fiedler, Carolina Ganss, Eva M. Kulik, Nadine Schlueter, Clemens Walter.

Funding acquisition: Julia C. Difloe-Geisert, Clemens Walter, Carolina Ganss, Nadine Schlueter.

Corresponding author

Correspondence to Julia C. Difloe-Geisert.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the local Ethics Committee of the University of Freiburg (application no. 288/17) and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

Julia C. Difloe-Geisert received an unrestricted grant from the Swiss Society of Dentistry (SSO) related to this article. Clemens Walter received an unrestricted grant from the Swiss Society of Dentistry (SSO) related to this article. Sarah Fiedler declares that she has no conflict of interest related to this article. Eva M. Kulik declares that she has no conflict of interest related to this article. Carolina Ganss declares that she has no conflict of interest related to this article. Nadine Schlueter declares that she has no conflict of interest related to this article.

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Difloe-Geisert, J.C., Fiedler, S., Kulik, E.M. et al. Interdental biofilm reduction and composition after use of an activated and inactivated side-to-side toothbrush — a proof-of-principle clinical study. Clin Oral Invest 26, 2909–2919 (2022). https://doi.org/10.1007/s00784-021-04273-0

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