Toothbrush design & methods

Which purpose of toothbrushing directly involves the gingival tissues?

Stimulation

Which purpose of toothbrushing relies on the dentifrice?

Applying its ingredients

Which three motions do untrained patients most commonly use?

Horizontal scrub, rotary, up and down

Which motion do most patients default to when no method has been taught?

Reciprocating horizontal scrub

Early toothbrushing was originally tied to what?

Religious ritual

Chew sticks were made by crushing one end of what?

Twigs or roots

What did William Addis observe that inspired his toothbrush?

A guard sweeping

William Addis made his handle from what?

Animal bone

Early Chinese bristled brushes used which bristles?

Horse or boar hair

Who held the first U.S. toothbrush patent and mass produced them?

H.N. Wadsworth

What shortage pushed handles toward celluloid?

Meat rationing

Which company first made nylon bristles?

Du Pont

What made nylon bristles gentler than earlier bristles?

Rounded ends

Which G.E. feature boosted electric toothbrush sales?

Cordless and rechargeable

What made the original electric toothbrush dangerous?

Line voltage

What was the first electric toothbrush called in the U.S.?

Broxodent

Who wrote Mouth Hygiene and told hygienists to teach brushing to school children?

Alfred C. Fones

Dr. Koecker recommended brushing with which bristle texture?

Hard

Which organization developed toothbrush design and technique guidelines?

AAP

Who prescribed the use of the Miswak?

Prophet Mohammed

A brush head's width is meant to cover which landmark?

Intercuspal distance of first molar

A brush head's length is meant to cover how many teeth?

2-3 posterior teeth

Recommended width of a toothbrush head?

8-9.5 mm

Recommended length of a toothbrush head?

25-32 mm

Recommended height of a toothbrush head?

11 mm

Bristles on a brush head are grouped into what?

Tufts

Which part connects the head to the handle?

Shank

Toothbrushes are classified by head size, bristle texture, and what else?

Handle design

Which handle design suits a patient with limited dexterity?

Specialty design

Besides baby/child and specialty, which handle designs exist?

Straight or angled

Which adult-sized brush category exists within head size classification?

A range of adult sizes

Which bristle material does not split or abrade?

Nylon

Which bristle material is easier to clean and can be standardized?

Nylon

Natural bristles come from which source?

Hog hair

Which newer bristle materials are compostable?

Bamboo and cornstarch

What does bristle texture measure?

Resistance to pressure

A bristle is 0.35 mm in diameter. What texture is it?

Hard

A bristle is 0.25 mm in diameter. What texture is it?

Medium

A bristle is 0.19 mm in diameter. What texture is it?

Soft

A bristle is 0.12 mm in diameter. What texture is it?

Extra soft

Which texture is ideal for most patients?

Soft

Which texture is used for post-surgery or sensitive patients?

Extra soft

Hard bristles are only potentially appropriate for which use?

Dentures

Which inappropriate texture do many patients report using?

Medium

Besides diameter, which factor changes bristle stiffness?

Water uptake

Which two other factors affect bristle texture besides water uptake?

Temperature and frequency of use

What happens to stiffness as filament length decreases?

Increases

A tuft with more bristles will feel what?

Stiffer

What is heat-treating nylon to seal and round the tips called?

End rounding

Why were round or tapered tips adopted over blunt-cut tips?

Less abrasive to soft tissue

Which bristle profile is best for lingual surfaces?

Convex

Which bristle profile is best for facial surfaces?

Concave

Which bristle profile performs best interproximally?

Multileveled

Multileveled bristles outperform which profile?

Flat

Which powered brush type reverses the tooth's negative charge?

Ionic

Which powered brush type adds sound waves to filament movement?

Sonic

Which powered brush type removes debris through bristle motion alone?

Mechanical

Mechanical, sonic, and ionic categories are based on what?

Bristle movement

A brush plugged into an outlet has which power source?

Direct

Which brush motion is consistent back-and-forth movement?

Oscillation

Which brush motion makes bristles move side-to-side?

Vibrational

Which motion pairs back-and-forth movement with 360° circles?

Rotation-oscillation

Which vibrational brush cannot be heard by the user?

Ultrasonic

Typical speed of a reciprocating powered brush?

3,800-7,600 pulses/min

Typical speed of a pulsation-type powered brush?

40,000 pulses/min

Powered brushes reduce plaque by how much versus manual?

10-20%

Powered brushes reduce gingivitis by how much versus manual?

10%

Compared with manual brushes, powered brushes are less likely to damage what?

Gingival tissues

Which feature helps an aggressive brusher on a power brush?

Automatic shutoff

Which handle factor must be considered for a limited-dexterity patient using a power brush?

Handle weight

Which brush type is indicated when a caregiver must brush for the patient?

Powered

A patient has failed repeated attempts with traditional biofilm removal. Which brush is indicated?

Powered

Which is the only method effective in cleaning the sulcus?

Bass

Which method is preferred for most patients?

Modified Bass

A child can't master the Bass technique. Which method is most appropriate?

Rolling

A patient has orthodontic brackets and a bridge. Which method is most effective?

Charters

Which method massages the gingiva and produces slight blanching?

Stillman

Which method is also called sulcular brushing?

Stillman

Which method has clenched teeth and a circular motion inside the cheeks?

Fones

Which method is not appropriate for adults?

Fones

Which method is also called vertical brushing?

Leonard

Which method is associated with excessive toothbrush abrasion?

Horizontal

Which physiologic method follows the pattern of food in the mouth?

Smith

Which method combines horizontal, vertical, and circular strokes?

Scrub

Which method is not appropriate because of excess pressure risk?

Scrub

Which method uses the toe of the brush on the lingual of anterior teeth?

Rolling

Which method starts with bristles on the occlusal surface?

Smith

Which method uses an in-and-out stroke on the lingual surfaces?

Fones

Adding a rolling stroke after the vibratory motion produces which type of method?

Modified

What is the Modified Bass technique?

Bass plus a coronal roll

Which direction is the roll in a Modified method?

Coronally

Bristle angle for Bass?

45° apically

Bristle angle for Charters?

45° toward occlusal

Bristle angle for Leonard?

90° to long axis

Bristle angle for Horizontal?

90° to long axis

Which motion defines the Bass technique?

Light horizontal vibration

Which motion defines the Charters technique?

Circular vibration

Which motion defines the Leonard technique?

Up and down

Which motion defines the Rolling method?

Roll apical to occlusal

After positioning, how does Stillman proceed?

Rotate 45° and vibrate over crown