Comparison of Three types of Tooth Brushes on Plaque and Gingival Indices: A Randomized Clinical Trial

Amir Moeintaghavi1, Naser Sargolzaie1, Mehrnoosh Rostampour2, Sara Sarvari1, Sanaz Kargozar1, Shideh Gharaei1, *
1 Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
2 Qom Dental School, Qom University of Medical Sciences - Oral and Maxillofacial Radiology, Qom, Islamic Republic of Iran

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Creative Commons License
© 2017 Moeintaghavi et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran; Tel: +1-7783219494; E-mails:,



To compare clinical results of three types of manual tooth brushes on plaque removal efficacy and gingivitis.


This study is a single blind randomized trial with crossover design which involved 30 periodontaly healthy individuals. Professional plaque removal and oral hygiene instruction were performed for all the participants in the first step of our study followed by asking them to avoid brushing for 2 days. Thereafter plaque and gingivitis scores were measured using plaque and gingival indices (PI and GI). Then subjects were instructed to use Pulsar tooth brush for a two-week period and then, GI and PI indices were assessed again. After passing one-week period for wash out, subjects didn't brush for 2 days and indices were recorded again. The same procedure was done for CrossAction, and Butler 411 tooth brushes respectively and at the end of the study these variables were analyzed using SPSS software ver.16. Repeated measurement ANOVA test was used to compare the scores between different brushes.


Finding of this study reveals that using all three types of tooth brushes resulted in significant plaque and gingivitis reduction compared to baseline levels. Pulsar tooth brush was significantly more effective in diminishing PI and GI than Butler tooth brush (p=0.044 and 0.031 respectively).


According to our findings all 3 types of tooth brushes are effective in reduction of plaque and gingivitis and this reduction is significantly greater for Pulsar tooth brush compared to Butler and CrossAction tooth brushes.

Keywords: Tooth brushing, Gingivitis, Dental plaque index, Pulsar, CrossAction, Butler.