A new oral hygiene strategy.

This study was designed to see if toothbrush pressure could be considered a significant factor in the reduction of plaque among a group of orthodontic patients. Eleven orthodontic patients who had been identified previously as having chronic poor oral hygiene and the ability to tolerate only small toothbrush pressures (an average of 3 oz) were selected to participate in this study. At the beginning of the study, each of the patients was supplied with a specialized toothbrush feedback mechanism that was to be used in the routine home care. The feedback mechanism permitted the patients to gradually increase their tolerance to toothbrush pressure by moving from a target pressure of 2 oz to a target pressure of 16 oz over a period of several weeks. When the target pressure was reached, a light on the end of the brush mechanism came on, thus alerting the patient that the target had been reached. Only one of the eleven patients failed to improve her plaque score. There was, on the average, a 47% reduction in plaque scores. The statistical evidence indicates that the improved plaque scores were directly related to the higher toothbrush pressures. The present study was undertaken as an extension of a previous study that indicated good orthodontic toothbrushers used four and one half times more pressure than did chronically poor toothbrushers. This study suggests that poor toothbrushers can improve their oral hygiene significantly by increasing the pressure with which they brush.