Van der Sluijs E, Slot D E, Hennequin-Hoenderdos N L, Van der Weijden G A
Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Int J Dent Hyg. 2018 Feb;16(1):85-91. doi: 10.1111/idh.12262. Epub 2016 Dec 19.
It has been propagated by the dental care professionals to start toothbrushing the lingual aspect of teeth first. In general, it is assumed that these surfaces of teeth are more difficult to clean. The evidence to support this recommendation is sparse.
In this randomized controlled clinical trial using a split-mouth design, 46 students were included. Before the visit, the participants were requested to refrain from any oral hygiene procedure for 48 h. First, the plaque index (PI) score was assessed full mouth. Two randomly chosen contra-lateral quadrants were used to start brushing from the lingual aspect first. The opposing two quadrants were used to start brushing from the buccal aspect. After the brushing exercise was completed, full-mouth PI was scored again. Subanalyses were performed for the buccal, lingual and approximal surfaces.
At baseline, there was no statistically significant difference between the two sets of contra-lateral quadrants (P = 0.770). Starting at the lingual aspect of the lower jaw resulted in a 55% reduction of plaque scores in comparison with 58% when the brushing exercise was started buccally. [Correction added on 16 January 2017, after first online publication: In the preceding sentence, the percentage reduction of plaque scores when the brushing exercise was started buccally, was previously wrong and has been corrected to 58% throughout this article.] The difference in mean plaque scores between brushing orders was 0.04, which was not significant (P = 0.219). None of the subanalyses revealed any significant differences for the isolated surfaces.
Using a manual toothbrush reduced the plaque scores between 55 and 58% with no difference between brushing from either the lingual or buccal aspect first. Within the limitations of this study, a recommendation to start toothbrushing the lingual aspect is not supported by the outcome in this young student population.
牙科护理专业人员一直倡导先从牙齿舌面开始刷牙。一般认为，牙齿的这些表面更难清洁。支持这一建议的证据很少。
在这项采用分口设计的随机对照临床试验中，纳入了46名学生。在就诊前，要求参与者48小时内不进行任何口腔卫生操作。首先，评估全口菌斑指数（PI）得分。随机选择两个对侧象限先从舌面开始刷牙。相对的两个象限则从颊面开始刷牙。刷牙练习完成后，再次对全口PI进行评分。对颊面、舌面和邻面进行亚组分析。
在基线时，两组对侧象限之间无统计学显著差异（P = 0.770）。从下颌舌面开始刷牙，菌斑得分降低了55%，而从颊面开始刷牙时降低了58%。[2017年1月16日首次在线发表后添加的更正：在前一句中，从颊面开始刷牙时菌斑得分降低的百分比之前有误，在本文中已全部更正为58%。]刷牙顺序之间的平均菌斑得分差异为0.04，无统计学显著性（P = 0.219）。亚组分析均未显示各单独表面有任何显著差异。
使用手动牙刷可使菌斑得分降低55%至58%，先从舌面或颊面刷牙之间无差异。在本研究的局限性内，对于年轻学生群体，本研究结果不支持先从牙齿舌面开始刷牙的建议。
