# A Randomized Crossover Clinical Trial Investigating 16‐Branched Filament Toothbrush Effects on Dental Plaque Removal

## TL;DR

A new toothbrush with 16-branched filaments was found to remove more dental plaque and cause less gum damage than a standard tapered filament toothbrush in older adults.

## Contribution

The study introduces a novel 16-branched filament toothbrush and demonstrates its superior plaque removal and reduced gum abrasion in a randomized crossover trial.

## Key findings

- The 16-BFE toothbrush removed 22.4% of plaque, significantly more than the 18.5% removed by the STF toothbrush.
- Only one instance of gingival abrasion was observed with the 16-BFE toothbrush out of 1700 areas examined.
- The 16-BFE toothbrush showed better plaque removal and less gum damage compared to the STF toothbrush.

## Abstract

Self‐care using an appropriate toothbrush is important for oral health management. The aim of this clinical trial in older adults was to evaluate the effectiveness of a prototype toothbrush with 16‐branched filament ends (16‐BFE) in dental plaque removal compared to a toothbrush with super tapered filament (STF).

Fifty older adults in Japan (13 males and 37 females, mean age 70.8 ± 8.7 years) with 20 or more teeth were enrolled in this study. Participants were divided into Group A (26 subjects) and Group B (24 subjects) and a randomized crossover clinical trial was conducted. Intervention Study I was performed for 3 min using a prototype 16‐BFE toothbrush. Dental plaque accumulation areas and gingival abrasion areas were measured before and after brushing by staining with MIRA‐2‐Ton. Intervention Study II was conducted in the same manner using an STF toothbrush. Crossover design was as follows: Group A was followed by an intervention study from I to II, while Group B was from II to I, with a washout period of 2 or 3 months. Analysis was performed using a modified PCR method (six sections of one tooth surface).

The average dental plaque removal rate using a 16‐BFE toothbrush was 22.4%, which was a significant reduction compared to 18.5% of the STF toothbrush (p < 0.05). There was only one small area out of 1700 areas examined regarding gingival abrasion when using a 16‐BFE toothbrush.

These results suggested that the 16‐BFE toothbrush provided a more effective way in dental plaque removal when compared to the STF toothbrush and was less harmful to the gingiva. Even though 16‐BFE showed a significant improvement, clinical relevance and long‐term effects needed to be further investigated.