Evaluation of the isosceles-configured SUN Teeth[TM] toothbrush in dental plaque removal and gingival health

Some are more tapered and some are oval or diamond-shaped, with bristle trim patterns evolving into bilevel, multilevel, and rippled trims, and some designs have criss-cross angulated bristle tufts.6 Frandsen recommended that a manual toothbrush should have soft nylon end-rounded bristles with a diameter of approximately 0.2 mm and a length of 10 mm with a multi-tufted, straight-trimmed brush head design.7 Brothwell et al. suggested that serrated tufts, raised toe bristles, and an angled head may offer better advantages.6 Another popular brush head design is the Oral-B CrossAction brush that was developed with tufts of bristles angled at 16° in both directions.8 This design was intended to support a brushing action that penetrates, lifts, and sweeps plaque away on both forward and backward strokes.8 Single-use clinical studies comparing the CrossAction brush to traditional manual brushes and 2 powered toothbrushes reported the CrossAction brush to have better plaque removal efficacy after single use than the comparison brushes.8 The unique angled arrangement of the bristles improved the potential for plaque removal on approximal surfaces and along the gumline by enhancing penetration of bristles into interproximal spaces.8 These findings were further supported by a multicentre descriptive study, receiving favourable responses from clients as well as dentists in better plaque reduction following the use of the manual CrossAction toothbrush over 12 weeks.9 Toothbrushing technique is also a major determinant of oral hygiene, and the modified Bass technique is widely recommended by dental professionals because it facilitates plaque removal from the gingival third of the teeth.10 This technique, however, requires the user to place the toothbrush bristles at a 45° angle at the gingival margin and move the brush back and forth gently followed by vertical sweeping strokes on all tooth surfaces.11 Most commonly used toothbrushes usually have flat surfaces, and the users must bend some part of the bristles/brush head to an angulation of 45° to follow the Bass technique.12 This placement has been shown to be challenging for many people and thus client compliance has been far less than ideal.5 The high prevalence of plaque-induced oral diseases indicates that many users fail to achieve adequate removal of plaque via normal manual toothbrush usage. [...]in clients who lack manual dexterity, adapting to the modified Bass method could be even more challenging.13 In contr