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To assess extrinsic stain removal efficacy of a power toothbrush and a dental prophylaxis followed by the use of a standardized American Dental Association (ADA) reference manual toothbrush.
This was a randomized, positive-controlled, examiner-blind, parallel group, two-week study. A Lobene stain examination was performed at baseline. Subjects were...
Context in source publication
Context 1
... and dentifrice manufacturers generally aim to include improved dental stain removal as a feature of new products to meet the demands of a society that values the cosmetic aspects of oral health. In instances of extrinsic or surface stains, which result from staining of the pellicle, this tooth discoloration can result from the consumption of beverages (e.g., tea, coffee, red wine), smoking, and the use of certain medications (e.g., chlorhexidene antibacterial mouthrinse). Intrinsic stains, or those below the tooth surface, can result from the use of tetracycline antibiotics, dental fluorosis, or the natural dental aging process ( Figure 1). Intrinsic stain can be removed by means of a peroxide-containing agent (bleaching gel/strip or a tray-based system) placed on the external surfaces of the teeth that bleaches through the enamel. 1-2 There appears to be a growing demand for this type of tooth whitening procedure that can be accomplished using a home bleaching kit or by a dental professional in a dental office. Extrinsic stain removal is one of the functions of the scaling and polishing procedure done during a prophylaxis performed by dental professionals during an office visit to help maintain oral health and prevent periodontal disease. The dental prophylaxis, as defined by the American Dental Association (ADA) 3 and the American Dental Hygienists’ Association (ADHA), 4 states stain removal is accompanied by removal of plaque, both supragingival and subgingival (i.e., below the gumline), and calculus. New models of toothbrushes can be assessed for their extrinsic stain removing potential both in the laboratory and in clinical studies. In a laboratory investigation comparing the removal of stained pellicle from the surface of enamel specimens with two powered brushes (Sonicare ® , Philips, Snoqualmie, WA, USA and Oral-B ® Plaque Remover, P&G, Cincinnati, OH, USA) and a standardized manual brush, the power brush with the oscillating-rotating action (Oral-B) was found to be superior. 5 In a series of four independent 2-week clinical studies of healthy adults with longstanding visible extrinsic stain on the facial surfaces of the 12 anterior teeth, a prototype- powered toothbrush group (Crest ® SpinBrush ® Pro Whitening, model formerly distributed by P&G, Cincinnati, OH, USA) was compared with a positive control powered toothbrush group (Sonicare ® Personal 4100), and the prototype power toothbrush removed extrinsic stain at least as well as the positive control toothbrush across these four studies. 6 Oral-B developed a specialized brush head (Oral-B Pro White), featuring an oval brush head with 16 outer tufts of filaments for regular cleaning and a thermoplastic elastomer polishing cup at the center of the head. In a 6-week clinical study that included naturally occurring extrinsic tooth stain removal, this brush head was compared with a standard brush head (EB17), both in combination with a recently developed powerbrush handle with an oscillating/rotating/pulsating action (Oral-B ® ProfessionalCare ® Series) and was also compared with a leading high frequency power brush (Philips Sonicare ® Elite ® ). 7 Greater removal of extrinsic tooth stain was seen with the specialized Oral-B brush head for both tooth stain (Lobene stain index) and tooth shade (Vitapan Shade Guide) measurements. In addition to improved efficacy of plaque removal normally expected of new models of toothbrushes manufacturers are being challenged to offer an improved capacity for extrinsic stain removal to meet the growing esthetic demand by the public. In order to guide the public’s choice of oral hygiene products clinical studies are required to evaluate the relative stain removal efficacy as new products are introduced (Figure 2). The present study used the Lobene stain index to measure the amount of stain removed at the end of a 2-week period in one group of subjects (Group 1) who used the novel Oral-B Vitality Pro White (Oral-B Vitality with Oral-B Pro White brush head) and a second group (Group 2) who received a routine dental prophylaxis followed by use of a standardized ADA reference manual brush (i.e., a positive control group). 8 An additional analysis compared stain removal in the two treatment ...
Citations
... Việc đánh bóng được thực hiện với tay khoan chậm tốc độ 2500 vòng/phút, sử dụng bột đánh bóng hạt mịn nhằm tránh làm mòn và xước men răng [15]. Theo nhiều Terezhalmy Geza (2008), đánh bóng răng có khả năng loại bỏ các vết nhiễm màu ngoại sinh trên bề mặt răng [16]. Kết quả của chúng tôi cho thấy sau đánh bóng, giá trị L* tăng trong khi giá trị b* giảm xuống ở cả ba nhóm trà, cà phê và coca. ...
Background: Tooth bleaching is an effective method to remove both endogenous and exogenous stains. This study aims to evaluate and compare the bleaching efficacy of tea, coffee and cola stains on teeth. Materials and Methods: 30 bovine tooth samples were divided into three groups: tea, coffee and cola (n = 10/group). Staining was obtained by soaking the tooth samples for 3 weeks in each drinks. Before bleaching, tooth samples were polished with fine pumice powder and slow-speed handpiece for 10 seconds, speed of 2500 rpm. The bleaching process was performed with 10% carbamide peroxide for 14 days, 8 hours/day. The effectiveness of the bleaching process is evaluated through the change in the brightness (L*), saturation (a*, b*) values and the total color change (DE*) of the CIELAB system with Crystaleye spectrocolorimeter. Results: After bleaching process, all three stained groups showed the color changes in the following direction: increase L*, decrease a*, decrease b*. The polishing phase could remove part of the staining and the whitening phase achieved the fastest bleaching effect after 1 week. The tea group achieved a greater color change than the cola group during all phases and greater than the coffee group at the polishing phase (p<0.05). Conclusions: The polishing phase is effective in removing the exogenous stains on teeth due to beverage consumption. The bleaching efficacy between the teeth stained with tea, coffee and cola is different, in which the teeth stained with tea have a higher whitening effect. Key words: tea, coffee, cola, extrinsic stain, bleaching
... All subjects performed dental prophylaxis before the rst evaluation time (D0). This procedure has the potential to remove extrinsic stains [33] such as those that impregnate the enamel surface due to smoking, resulting in similar initial whiteness. A previous study evaluated the e cacy of prophylaxis and in-o ce bleaching to remove cigarette stains from teeth [14]. ...
... A previous study evaluated the e cacy of prophylaxis and in-o ce bleaching to remove cigarette stains from teeth [14]. Although in-o ce bleaching with 35% hydrogen peroxide promotes a more expressive color change, prophylaxis e ciently removed the extrinsic stains, proving that both techniques are effective [6,16,33]. ...
Objectives
To evaluate the effect of smoking on tooth whitening and color change after at-home bleaching.Materials and methodsThis is a cohort study evaluating two groups of participants: NS- non-smokers (n = 24) and S- smokers (n = 16). All subjects were treated with at-home bleaching using 22% carbamide peroxide (CP) in individual trays for 1 h per day, during 14 days. The color was evaluated before bleaching (D0-baseline), and one day (D1), 15 days (D15), and one month (D30) after bleaching. The color coordinates were measured using the VITA Easyshade™ spectrophotometer and the whiteness index (WI D - Whiteness Index for Dentistry) and color differences (ΔE 00 ) for S and NS at different times were calculated. Color changes between S and NS subjects for specific teeth (CI- Central Incisors, LI- Lateral Incisors, and C- Canines) were analyzed using Mann-Whitney test (α=0.05).ResultsThere was no significant difference of WI D between S and NS subjects at baseline (D0). NS participants showed higher WI D than S at D1, D15, and D30 (p < 0.05). NS showed higher ΔWI D for CI and C between D0 and the other evaluation times (D1, D15, and D30) compared to S. Smokers showed higher darkening of CI than NS in ΔWI D D30-D1 (p < 0.05). Color change (ΔE 00 ) findings had the overall behavior similar to ΔWI D . ΔWI D and ΔE 00 values for all evaluation times were within the acceptability threshold.Conclusion
Although smoking showed some effects on the at-home bleaching treatment using 22% CP, teeth whiteness and color changes are clinically acceptable for both groups. Clinical significance: At-home bleaching is a widely performed treatment, however there is a lack of evidence using 22% carbamide peroxide gel in smokers. Although the central incisors showed significant darkening (lower WI D ) in smokers at 30 days after bleaching, the whitening index was considered clinically acceptable.
... Several methods for removing stains have been reported, including professional care by a dentist or dental hygienist/dental nurse or self-care with a toothbrush. Professional care, such as mechanical prophylaxis (4) with polishing paste or air-powder polishing combining water and granular sodium hydrogen carbonate (baking soda) removes staining, but it requires time and effort as well as treatment costs each time. In contrast, self-care using dentifrice is easier than professional care because it is done at home. ...
Background: This study aimed to investigate the combined effect of baking soda and electric toothbrushing on the
removal of artificial extrinsic stain in vitro.
Material and Methods: Flat enamel surfaces of 15 bovine incisors were artificially stained with 10% citric acid / 3% ferric chloride solution followed by 1% tannic acid solution. These specimens were randomly divided into three groups
(n = 5) – Group S+B: brushing with an electric toothbrush and baking soda, Group S+C: brushing with an electric
toothbrush and fluoride dentifrice, Group S: brushing only with an electric toothbrush. Color values (L*, a*, and b*)
and surface roughness were measured before and after brushing (after 1, 2, 3, and 5 min). The data were statistically
analyzed using two-way analysis of variance and Tukey’s honest significant difference test as a post hoc test (p < 0.05).
Results: The L* value of Group S+B increased over time, and was significantly different between before brushing and
at 5 min (p < 0.05). A significant difference in the ΔE* value of Group S+B was found at 5 min (p < 0.05). However,
no significant difference was found in the ΔE* values of Group S+C and Group S. No significant differences in Ra
were found in any of the groups.
Conclusions: The results of this study suggest that the combined use of baking soda and electric toothbrushing has
an excellent stain-removing effect compared with electric toothbrushing with a fluoride dentifrice. Additionally, the
changes in surface roughness were similar to the changes caused by the use of general dentifrices.
... Screened subjects received an oral soft tissue (OST) examination. Extrinsic dental stains and tooth shades of the 12 anterior teeth were evaluated using the Lobene Stain Index (LSI) [21,22] and the VITA Bleached guide 3D-Master. Recruited subjects were 18-70 years of age, with a total extrinsic facial tooth stain mean score of at least 1.80, according to LSI. ...
... It can only be used to assess extrinsic stains. Staining is classified regarding its intensity (no stain, light stain, moderate stain, and heavy stain) and area (no stain detected, stain covering up to 1/3 of the region, stain covering > 1/3 to 2/3 of the region, and stain covering > 2/3 of the region) [42]. ...
Besides prevention of caries and periodontitis, an increasing number of oral care products focus on teeth whitening. The aim of this review is to summarize and discuss frequently used whitening agents and their efficacy from a chemical viewpoint. Therefore, a comprehensive literature survey on teeth whitening agents and products was conducted. The current whitening methods are analyzed and discussed from a chemist’s viewpoint. Frequently used whitening agents are abrasives (mechanical removal of stains), antiredeposition agents (prevention of deposition of chromophores), colorants (intended to lead to a white color), proteases (degradation of proteins), peroxides (oxidation of organic chromophores), and surfactants (removal of hydrophobic compounds from tooth surface). In-office bleaching using peroxides is effective, but side effects like tooth sensitivity or a damage of the natural organic matrix of enamel and dentin may occur. The applicability of abrasives in teeth whitening is limited due to potential tooth wear, especially when toothpastes with high RDA values are used. The effect of other whitening agents in vivo is often unclear because of a shortage of placebo-controlled clinical trials.
... Adsorption of stain is one factor in the deterioration of dental esthetics. Professional dental prophylaxis is known to remove extrinsic stain efficaciously (3). Although professional prophylaxis by a dental hygienist removes staining, the procedure incurs a cost each time. ...
Background
This in vitro study aimed to clarify the combined effect of electric toothbrushing and dentifrice on the removal of artificial stain.
Material and Methods
Twenty-five bovine incisors were cut at the cervix and the crown was embedded in auto-cured acrylic resin. Specimens were abraded using #240 SiC paper to obtain a flat enamel surface, and 20 specimens were treated with 10% citric acid / 3% ferric chloride solution followed by 1% tannic acid solution to produce surface staining. They were divided into four groups: 1) brushing with an electric toothbrush and whitening dentifrice (group S+B); 2) brushing with an electric toothbrush and fluoride dentifrice (group S+C); 3) brushing with an electric toothbrush and no dentifrice (group S); and 4) no brushing (control group). The remaining five specimens were used as a baseline. Color values (L*, a*, and b* were measured before brushing (0 min), and at 1 min, 5 min, 10 min, and 20 min using a microscopic area spectrophotometer. The color change (ΔE) was calculated by subtracting the baseline values from the final color values obtained at each time point. The data were statistically analyzed using two-way repeated-measures analysis of variance and Tukey’s honest significant difference test as a post hoc test (p<0.05).
Results
The L* values of groups S+B and S+C increased over time (p<0.05), but no significant differences were observed in group S and the control group at any of the time points (p>0.05). Groups S+B and S+C demonstrated greater ΔE values than group S.
Conclusions
The combination of electric toothbrushing and dentifrice removed the artificial stain more effectively than brushing without dentifrice. However, the stain removal was limited. The two dentifrices evaluated in this study exhibited similar stain removal effects.
Key words:Color change, stain removal, dentifrice, electric toothbrush, whitening effect.
... Powered toothbrushes are also suggested to reduce extrinsic tooth stain. 61 The combined effect of a powered toothbrush and a whitening dentifrice, therefore, presents itself as an area of interest for future investigation. ...
Objective:
The aim of this systematic review was to assess the effect of a whitening dentifrice (WDF) relative to a regular dentifrice (RDF) on the reduction of natural extrinsic tooth surface discoloration (ETD).
Materials and methods:
The MEDLINE-PubMed, Cochrane-CENTRAL and EBSCO-Dentistry and Oral Sciences databases were searched, up to April 2017. The inclusion criteria were as follows:(randomized)controlled clinical trials, healthy subjects ≥18 years of age, studies comparing WDF with RDF, a follow-up period of at least 6 weeks and studies scoring ETD as the stain area/extent, stain intensity or a composite score. Studies using an induced staining model were excluded.
Results:
Independent screening of 851 unique papers resulted in 21 eligible publications, which included 32 comparisons. The descriptive analysis illustrated that the majority of comparisons showed a significant effect on ETD, in favour of WDF over RDF. The meta-analysis substantiated this observation and revealed that the difference of means (diffM) comparing WDF and RDF was a reduction for stain area of -0.44 [(95% CI: -0.55; -0.339) (P<.00001)] according to the original Lobene Stain Index; this result is in favour of the WDF. For the modified Lobene Stain Index, the diffM was -0.41 [(95% CI: -0.71; -0.10) (P=.009)]. For overall stain intensity, the diffM was -0.35 [(95% CI: -0.44; -0.25) (P<.00001)], and the composite score was -0.39 [(95% CI: -0.57; -0.21) (P<.0001)] and -0.54 [(95% CI: -0.66; -0.43) (P<.00001)]. Subgroup analysis differentiating between products that contained added chemical antidiscoloration agents showed a similar pattern.
Conclusion:
In this review, nearly all dentifrices that are specifically formulated for tooth whitening were shown to have a beneficial effect in reducing ETD, irrespective of whether or not a chemical discoloration agent was added.
... The Lobene Stain Index was used to score the amount of stains on specimens in the current study. This index is widely used for the assessment of stainability of composite resins, and its reliability has been confirmed in many previous studies (30)(31)(32)(33)(34)(35). However, this measure is subjective and may be considered a limitation of the current study. ...
... The Lobene Stain Index was used to score the amount of stains on specimens in the current study. This index is widely used for the assessment of stainability of composite resins, and its reliability has been confirmed in many previous studies (30)(31)(32)(33)(34)(35). However, this measure is subjective and may be considered a limitation of the current study. ...
Background:
Color change is one major drawback of tooth-colored resin-based restorations.
Objectives:
This study aimed to assess the color stability of three commonly used resin-based restorative materials upon exposure to tea and coffee.
Materials and Methods:
Discs were fabricated from Spectrum TPH (Dentsply/Caulk), Denfil (Vericom), and Filtek Z250 (3 M) microhybrid composites and immersed in coffee and tea solutions for two hours on the first day and the whole of the second, third, and fourth days. The color was assessed visually and recorded using the Lobene Stain Index after each period of immersion. The color change of the three composite resins was compared using the Kruskal-Wallis test, Mann-Whitney U test, and Friedman test. The level of significance was set at 0.05. The Cohen’s Kappa was also calculated to assess inter-rater agreement.
Results:
The three composite resins showed statistically significant color changes after four days of immersion in a coffee solution (P = 0.014), but their color change in the tea solution was not significant (P > 0.05). A comparison of color changes in the composites after one (two hours) and four days of immersion in tea and coffee solutions revealed a significant difference in color changes between Spectrum TPH and the other two composites (P < 0.001).
Conclusions:
The three microhybrid composites used in this study showed variable color stability upon exposure to a coffee solution. The color stability of Spectrum TPH was inferior to that of Denfil and Filtek Z250.
... [3] In spite of numerous techniques and materials being available for getting rid of the plaque and extrinsic stains, none has qualified as a gold standard treatment modality till date. Routine home dental polishing done with powered toothbrush [5,6] and whitening paste, [7,8] although effective, still lacks efficiency in inaccessible areas, thus necessitating a more efficient professional polishing other than conventional rubber-cup polishing. ...
Objectives: Over the years, professional dental prophylaxis has involved the use of rubber‑cup, bristle brush, and abrasive paste for coronal polishing. Although air polishing is an excellent alternative for removal of tooth stain and dental plaque, very few studies have compared their efficacy in vivo. The present study attempts to evaluate and compare the efficacy of air polishing (test) alone versus rubber‑cup polishing (control). Materials and Methods: A total of 35 individuals having generalized mild to moderate gingivitis were enrolled as the study population after obtaining their informed consent. Before commencement of the study, all subjects underwent scaling to remove calculus deposits (if any), following which the ipsilateral quadrant of the patient’s mouth was randomly assigned as the test side and the contralateral quadrant of the same arch was assigned as the control side for polishing procedures. Time employed for both methods of polishing was held constant at 5 min for each technique. Subjects were assessed before and immediately after polishing and again after 15 days following treatment, for plaque and gingival status along with gingival bleeding. Results: Overall, the results of the intra‑group comparison of both the polishing procedure sites indicated similar but significant plaque and gingival status changes, whereas the inter‑group comparison showed no
significant difference between the efficacies of both the groups. Conclusions: Air polishing and the rubber‑cup, bristle brush with paste polishing demonstrated equivalent efficacy regarding removal of supragingival plaque and in reducing gingival inflammation.
