J Korean Acad Oral Health.  2019 Sep;43(3):111-117. 10.11149/jkaoh.2019.43.3.111.

Efficacy of different tooth-brushing methods for removing dental plaque

  • 1Department of Preventive & Public Health Dentistry, School of Dentistry, Seoul National University, Seoul, Korea. stbluewi@snu.ac.kr


This study aimed to measure the efficacy of different tooth-brushing methods for removing plaque in Korea.
This study was conducted with the approval of the Institutional Review Board (IRB) of the Seoul National University School of Dentistry (S-D20180021). Thirty participants aged between 19 and 30 years, who did not have periodontal disease, were enrolled in this observational study. Participants were given the same type of toothbrush and toothpaste and asked to brush their teeth as they usually would. During brushing, participants were recorded with a camcorder that was attached to a mirror. Participants were aware they were being recorded. After they had finished brushing their teeth, a dental plaque staining and oral plaque index (PI) examination was performed. The PI score was measured using the Turesky modified Quigley Hein Index. Brushing methods were classified as rolling, horizontal, vertical, circling, and oblique. Skipped surfaces were recorded separately. Following this, statistical analysis was performed using SPSS software.
Most surfaces of the mouth were skipped. The most commonly used brushing method was the circling method, followed by the vertical, horizontal, rolling, and oblique methods. The most frequently used method on the vestibular surface was circling, with 52.92% of the oral surface skipped. The oblique brushing method had the lowest mean PI score with a mean±SD of 1.73±0.82. The mean PI score of the skipped surfaces was the highest with a mean±SD of 2.52±0.81. We also analyzed the linear mixed model considering the different lengths of time spent brushing. Both the brushing method used and the time spent brushing had a significant effect on the PI score, but no interactions between these were observed. In areas where a horizontal brushing method had been used, the PI score was significantly decreased.
This study suggests that the horizontal brushing method is an efficient tooth-brushing method compared to the other methods. Additionally, tooth-brushing for more than 10 seconds on 3 to 4 teeth area was effective in removing dental biofilm.


Dental plaque index; Oral hygiene; Tooth-brushing; Video recording
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