When as well as possible is not good enough
PD Dr. Kristina Bertl, PhD MSc MBA
Brushing teeth ‘properly’ continues to prove a challenge for our patients (and possibly for us as well)! Although our significant educational work has been very successful in ensuring that tooth brushing is seen as standard practice by the majority of people, and is carried out accordingly, the quality and efficiency of brushing leaves a lot to be desired.
One research group from Germany (Deinzer et al. 2018) has addressed this subject and raised an interesting question: ‘How do young people brush when asked to clean their teeth as well as possible?’
In total, just under 100 young adults took part in the study. All participants were asked to brush their teeth as well as possible, using a manual toothbrush and a selection of tools for interdental (area) cleaning. The tooth brushing itself was recorded via a camera before subsequently being analysed. The results were then compared with a similar study, in which the participants were asked to brush their teeth as they normally would (Winterfeld et al. 2015). These two studies revealed some fascinating results:
- When asked to clean their teeth as well as possible, young adults brush for significantly longer than usual (3.4 minutes compared to 2.6 minutes).
- Palatal or lingual surfaces were brushed comparably in both groups, in that they were similarly neglected; on average, the participants brushed palatal/lingual surfaces for just 25–30 seconds, but buccal and occlusal surfaces for two to three times longer.
- The brushing technique was horizontal scrubbing for 40% of the brushing time.
- Even after being asked to brush their teeth as well as possible, plaque remained at the margins in approximately 70% of sites.
From these results, it can be concluded that it is not the motivation that is lacking, but rather knowledge and technology. For us, this in turn means that we really need to teach young people the correct brushing techniques as well as specifically point out common problem areas such as palatal/lingual surfaces.
- Deinzer R, Ebel S, Blättermann H, Weik U, Margraf-Stiksrud J. Toothbrushing: to the best of one’s abilities is possibly not good enough. BMC Oral Health (2018) 18:167. Winterfeld T, Schlueter N, Harnacke D, Illig J, Margraf-Stiksrud J, Deinzer R, et al. Toothbrushing and flossing behaviour in young adults - a video observation. Clin Oral Investig. 2015;19(4):851–8.