Toothbrushing and flossing behaviour in young adults—a video observation

Clinical Oral Investigations volume 19, pages851–858(2015)Cite this article

Abstract

Objectives

Video observation studies of habitual oral hygiene from the 1970s revealed a striking neglect of brushing oral surfaces and unsystematic brushing patterns with frequent movements between areas. These findings were not systematically followed up; furthermore, nothing is known about whether subjects are able to floss sufficiently. Therefore, the aim of this video study was to analyse the performance of habitual toothbrushing and flossing.

Methods

A random sample of 101 18-year-olds was included. Toothbrush and floss were provided; habitual brushing/flossing was videotaped in a standardised setting and analysed with the video coding software INTERACT. Parameters of interest were toothbrushing duration, type of brushing strokes, brushing patterns, flossed interproximal spaces and flossing technique.

Results

The mean brushing duration was 156.0 ± 71.1 s; duration differed only slightly between the upper and lower jaw as well as between the right, left and anterior areas. However, oral surfaces were brushed distinctly shorter than vestibular surfaces (27.1 ± 27.8 s versus 72.1 ± 31.8 s; p ≤ 0.001). Participants brushed different areas of the mouth with different types of strokes, predominantly with horizontal and circular strokes. Brushing movements frequently alternated between areas (45.1 ± 22.4) not randomly but accumulated within a jaw with a tendency to move from the right to the left. Half of the participants flossed, but only one performed sufficiently.

Conclusions

There was a significant neglect of brushing oral surfaces and insufficient use of floss. Brushing patterns were similar to those observed in the 1970s.

Clinical relevance

Understanding habitual oral hygiene behaviour is essential for improving oral hygiene instruction strategies.

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Acknowledgements

The study was supported by grant of the DGZMK (Deutsche Gesellschaft für Zahn-, Mund- und Kieferheilkunde).

Conflict of interest and statement

The authors declare that they have no conflict of interest.

Author information

Affiliations

  1. Department of Conservative and Preventive Dentistry, Dental Clinic, Justus-Liebig-University, 35392, Giessen, Germany

    T. Winterfeld, N. Schlueter & C. Ganss

  2. Institute of Medical Psychology, Justus-Liebig-University, 35390, Giessen, Germany

    D. Harnacke & R. Deinzer

  3. Faculty of Psychology, Philipps-University, Marburg, Germany

    J. Illig & J. Margraf-Stiksrud

Authors
  1. T. Winterfeld
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  2. N. Schlueter
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  3. D. Harnacke
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  4. J. Illig
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  5. J. Margraf-Stiksrud
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  6. R. Deinzer
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  7. C. Ganss
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Corresponding authors

Correspondence to R. Deinzer or C. Ganss.

Additional information

Corresponding authors, R. Deinzer and C. Ganss, contributed equally.

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Winterfeld, T., Schlueter, N., Harnacke, D. et al. Toothbrushing and flossing behaviour in young adults—a video observation. Clin Oral Invest 19, 851–858 (2015). https://doi.org/10.1007/s00784-014-1306-2

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Keywords

  • Toothbrushing technique
  • Flossing technique
  • Oral hygiene behaviour
  • Video observation