Orientation and back-and-forth displacement of the toothbrush were measured by a combined three-axis accelerometer. Tooth brushing

behavior is a daily habit, therefore, it is not easily altered, even after professional instruction in the clinic. First, teaching brushing technique is a complex and time-consuming procedure. Second, from the perspective of movement sciences, skill training requires many repetitions of the same movements to incorporate them into an individual’s habitual motor program. The choice of toothbrush is usually a matter of individual Protein Tyrosine Kinase inhibitor preference rather than a demonstrated superiority of any one type [42]. The enthusiastic use of a toothbrush is, however, not synonymous with a high standard of oral hygiene. Adults, despite their apparent efforts, appear not to be as effective in their plaque removal as might

be expected. Most individuals reduce plaque scores by approximately 50% during tooth brushing. A 1-min brushing exercise in participants adhering to their customary brushing method, but all using the same type of toothbrush, observed a plaque score reduction of approximately 39% [42]. These results indicate that most people www.selleckchem.com/products/ly2157299.html are not effective brushers and probably live with considerable amounts of plaque on their teeth, despite brushing at least once a day. What currently is lacking is a systematic review that provides a reliable overview of tooth brushing efficacy through the process of systematically locating, appraising and synthesizing evidence from individual trials [9]. Professional recommendations for individual oral hygiene mostly include tooth brushing at least twice daily [43] and [44] for 2–3 min with gentle force [39] using the Bass technique or modifications of it [33] and [45] as suggested by American Dental Association. However, “gentle

force” is not defined clearly enough to be used in the clinical DOK2 situation. When brushing force is increased, more plaque is removed [46]. Numerous studies have reported brushing forces. Some of these previously reported tooth brushing forces were 2.95 N [47], 2.61 N [46], 2.96 N [48], 3.23. N [42], 2.3 N [39]. Force discrepancies might have been due to random effects from using different measuring systems and toothbrushes, and different gender, age and dental characteristics of the study groups. Burgett and Ash discussed the significant variation in the magnitude of brushing force (from 1.04 N g to 11.3 N) when using different measuring systems, toothbrush grips, toothbrushes and techniques [49]. In addition, no systematic review or evaluation of brushing forces has so far been performed that compares different sextants and tooth sites or of the effect of instruction on brushing technique. Very few studies have investigated the association between brushing force and gingival recession.