J Korean Acad Oral Health.  2024 Dec;48(4):216-222. 10.11149/jkaoh.2024.48.4.216.

Study on the plaque removal efficacy of single-tufted toothbrush: scoping review

• Lee Y
• Lee BD
• Jin BH

• KMID: 2563487
• DOI: http://doi.org/10.11149/jkaoh.2024.48.4.216

Abstract

Objectives
This study aims to evaluate the efficacy of single-tuft toothbrushes in removing dental plaque, particularly in areas that are difficult to reach using conventional toothbrushes. The study also explores the current level of awareness and usage of these brushes, and it identifies gaps in research and education regarding their application.
Methods
A scoping review was conducted using the framework proposed by Arksey and O’Malley and guidelines by Peters et al. Databases including PubMed, Scopus, and Korean academic repositories were searched using keywords like “single-tuft toothbrush” and “end-tuft toothbrush.” A total of 403 articles were initially identified, with 9 studies meeting the inclusion criteria. These studies included 8 randomized controlled trials and 1 in-vitro experiment, focusing on the effectiveness of single-tuft toothbrushes in various contexts.
Results
Single-tuft toothbrushes demonstrated superior plaque removal in challenging areas, such as interproximal surfaces of molars, lingual surfaces, and around orthodontic appliances. In combination with conventional toothbrushes, they showed significantly better results compared to conventional tools alone. However, they did not consistently outperform other interdental cleaning devices like floss or interdental brushes across all metrics. User satisfaction with single-tuft toothbrushes was high, especially among orthodontic patients, although their usage rate was significantly lower due to limited awareness and accessibility.
Conclusions
Single-tuft toothbrushes are highly effective as adjuncts to conventional oral hygiene tools, particularly in managing hard-to-reach areas. However, their overall efficacy in replacing other oral hygiene tools is limited. To maximize their potential, increased public awareness, improved accessibility, and targeted education programs are needed. Further research should explore their role in specific patient populations, such as those with orthodontic appliances or implant restorations.

Keyword

Dental biofilm; Dental plaque; End-tuft toothbrush; Scoping review; Single-tufted toothbrush

Figure

• 

  Fig. 1 Extraction fields.

• 

  Fig. 2 PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Review) flow diagram for the scoping review process.

Reference

References

1. National Association of Periodontology Professors. 2010. Periodontology. 5th ed. Gunja Publishing Co.;Seoul: p. 215–234.

2. Newman M, et al. 2012. Carranza's clinical periodontology. 11th ed. Jiseong Publishing Co.;Seoul: p. 239–250.

3. Hong JY. 2017; Periodontitis and systemic disease. Kyung Hee Medical Journal. 32:1–8.

4. Vyas T, et al. 2021; Chemical plaque control - A brief review. J Family Med Prim Care. 10:1562–1568. DOI: 10.4103/jfmpc.jfmpc_2216_20. PMID: 34123892. PMCID: PMC8144784.

5. Jeon HJ. 2018. Evaluation of the effectiveness of toothbrushing education methods for adults in their 20s and 30s [master's thesis]. Kyungpook National University;Daegu: [Korean].

6. Lang NP, Østergaard E, Löe H. 1972; A fluorescent plaque disclosing agent. J Periodontal Res. 7:59–67. DOI: 10.1111/j.1600-0765.1972.tb00632.x. PMID: 4272033.

7. Editorial Committee of Oral Health Textbook. 2016. Preventive Dentistry. Daehannarae Publishing Co.;Seoul: p. 101–121.

8. Davies RM, Jensen SB, Rindom-Schiott C, Löe H. 1970; The effect of topical application of chlorhexidine on the bacterial colonization of the teeth and gingiva. J Periodontal Res. 5:96–101. DOI: 10.1111/j.1600-0765.1970.tb00699.x. PMID: 4254175.

9. Löe H. 1979; Mechanical and chemical control of dental plaque. J Clin Periodontol. 6:40–47. DOI: 10.1111/j.1600-051X.1979.tb02116.x. PMID: 295293.

10. Research Society for Preventive Dentistry. 2010. Modern Preventive Dentistry. 3rd ed. Gunja Publishing Co.;Seoul: p. 66–71. p. 113–119.

11. Harris NO. 2006. Primary Preventive Dentistry. 6th ed. Daehannarae Publishing Co.;Seoul: p. 127–129.

12. So MH, Kim SS, Shin SB. 2010; A study on the use of oral hygiene products in some regions. J Korean Soc Dent Hyg. 10:1107–1119.

13. Im JN. 2019. Dental plaque removal efficacy of dental floss, interdental brushes, and single-tufted brushes. [master's thesis]. Namseoul University;Cheonan: [Korean].

14. Arksey H, O'Malley L. 2005; Scoping studies: Towards a methodological framework. Int J Soc Res Methodol. 8:19–32. DOI: 10.1080/1364557032000119616.

15. Peters MD, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. 2015; Guidance for conducting systematic scoping reviews. JBI Evid Implement. 13:141–146. DOI: 10.1097/XEB.0000000000000050. PMID: 26134548.

16. Wolffe GN. 1976; An evaluation of proximal surface cleansing agents. J Clin Periodontol. 3:148–156. DOI: 10.1111/j.1600-051X.1976.tb01862.x. PMID: 1067276.

17. Aykol-Sahin G, Ay-Kocabas B, Mert B, Usta H. 2024; Effectiveness of different types of toothbrushes on periodontal health in orthodontic patients with gingivitis: A randomized controlled study. BMC Oral Health. 24:1289. DOI: 10.1186/s12903-024-05084-x. PMID: 39455996. PMCID: PMC11515239.

18. Kim KH, Kim HK. 2024; Comparison of oral health care behaviors among Korean elders before and after the COVID-19 pandemic. J Health Res. 50:47–56.

19. So MH, Kim SS, Shin SB. 2010; A study on the use of oral hygiene products in some regions. J Korean Soc Dent Hyg. 10:1107–1119.

20. Lee DW, Moon IS. 2011; The plaque-removing efficacy of a single-tufted brush on the lingual and buccal surfaces of the molars. J Periodontal Implant Sci. 41:131–134. DOI: 10.5051/jpis.2011.41.3.131. PMID: 21811688. PMCID: PMC3139046.

21. Waerhaug J. 1952; The gingival pocket; anatomy, pathology, deepening and elimination. Odontol Tidskr. 60(Suppl 1):1–186.

22. Maliska AN, Weidlich P, Gomes SC, Oppermann RV, Maliska AN. 2006; Measuring early plaque formation clinically. Oral Health Prev Dent. 4:1–7.

23. Hasegawa I, Veríssimo C, Montalli VA, Sperandio M, Peruzzo DC. 2017; Effectiveness of a single-tufted toothbrush for control of newly formed dental biofilm. Braz J Oral Sci. 15:113. DOI: 10.20396/bjos.v15i2.8648761.

24. Aeran H, Tuli AS, Bartwal J, Vishnoi L, Aeran V. 2019; Comparison of the efficacy of conventional toothbrush and single-tuft brush for the control of dental plaque. Int J Oral Health Dent. 5:203. DOI: 10.18231/j.ijohd.2019.046.

25. Cunha , Peruzzo DC, Costa LA, Pereira ALP, Benatti BB. 2018; Effect of a single-tufted toothbrush on the control of dental biofilm in orthodontic patients: A randomized clinical trial. Int J Dent Hyg. 16:512–518. DOI: 10.1111/idh.12360. PMID: 30129268.

26. Kim HW, Song HK, Park EJ. 2021; Comparison of the effect of removing artificial dental plaque depending on various interdental cleaning products on the interdental surface of zirconia crowns. J Korean Acad Prosthodont. 59:291–298. DOI: 10.4047/jkap.2021.59.3.291.

27. Ashkenazi M, Salem NF, Garon S, Levin L. 2015; Evaluation of orthodontic and triple-headed toothbrushes when used alone or in conjunction with single-tufted toothbrush in patients with fixed lingual orthodontic appliances: a randomized clinical trial. N Y State Dent J. 81:31–37.

28. Lee JH, Yi SK, Kim SY, Kim JS, Kim HN, Jeong SH, et al. 2019; Factors related to the number of existing teeth among Korean adults aged 55-79 years. Int J Environ Res Public Health. 16:3927. DOI: 10.3390/ijerph16203927. PMID: 31623067. PMCID: PMC6843127.