Author(s): Tobias K Boehm, Clara S Kim, Sam Chui and Josephine Franc
Background: Aggressive tooth brushing can contribute to gingival recession, and we tested in a randomized clinical trial if use of a bristle-less tooth brush results in less recession compared to using a conventional soft brush. Methods: We recruited 23 subjects with gingival recession who received regular periodontal maintenance care at Western University of Health Sciences Dental Center, and who did not exhibit signs of acute dental and systemic disease, occlusal discrepancies and para-functional habits. We randomly assigned these subjects to two groups, one using a soft nylon-bristled tooth brush, and the other group using the experimental tooth brush that contains a brush head with short, soft, rubbery cones. Both groups received regular periodontal maintenance and periodontal exams by blinded examiners every 3-4 months measuring probing depth, bleeding on probing, plaque indices. Tooth brush use was monitored by phone follow-up and measuring tooth brush wear of the tooth brushes assigned to subjects. Gingival recession was assessed clinically and through use of a stent on diagnostic casts obtained at each visit. Results: Average probing depths, plaque levels, and the number of sites with bleeding on probing did not change over one year. Subjects were compliant with tooth brush use as tooth brushes showed consistent wear patterns, but with much less tooth brush damage in the bristle-less brushes. There was a small, but statistically significant improvement of gingival recession (0.4 mm, p<0.01) at sites with gingival recession in the experimental tooth brush group compared to the control group and compared to baseline gingival level. Conclusion: A bristle-less brush appears to be more suitable in preventing additional gingival recession in patients with a history of aggressive tooth brushing.
