Ralf Adam

To assess the relative efficacy of a new entry-tier oscillating-rotating (OR) electric toothbrush versus a sonic electric toothbrush over 4 weeks of use for plaque and gingivitis reduction. This single-center, examiner-blind, two-treatment, parallel-group, randomized clinical study enrolled adult participants who had evidence of gingivitis and plaque at baseline. Participants were randomly assigned to use either an entry-tier OR toothbrush (Oral-B iO2) with the Ultimate Clean brush head in Daily Clean mode or an advanced sonic toothbrush (usmile Marble-Art) used with the usmile Advanced Whitening brush head in Clean mode (and at the high-intensity level). Both groups brushed with a standard sodium fluoride dentifrice. Participants were assessed for gingivitis (Modified Gingival Index and the Gingival Bleeding Index) and plaque (Rustogi Modification of the Navy Plaque Index) at baseline and after 4 weeks of twice-daily use. Plaque was also assessed after a single use at baseline. Both toothbrushes statistically significantly reduced gingivitis after 4 weeks of use and plaque after a single use and after 4 weeks (P< 0.001 for all). The OR toothbrush, relative to the sonic toothbrush, demonstrated a statistically significantly greater reduction in Modified Gingival Index score and number of bleeding sites (P< 0.001) and was associated with a significantly greater number of users transitioning from gingivitis to a state of gingival health (i.e., < 10% bleeding sites; P= 0.038) by the end of the study. The OR toothbrush likewise demonstrated greater efficacy with respect to plaque reduction after a single use (whole mouth, interproximal, and gingival margin; P< 0.001 for all) and after 4 weeks of use (whole mouth and interproximal; P< 0.001 for both). The novel entry-tier OR toothbrush offers significantly greater plaque control and gingivitis reduction relative to the advanced sonic toothbrush model.

Understanding the efficiency of various toothbrush technologies is essential for achieving optimal oral health. Dr Ralf Adam, who leads a dedicated team at Procter & Gamble in Germany, is keen to investigate the complexities of these technologies. His team have provided new insights into the best toothbrush types for plaque removal and the maintenance of gum health. By highlighting the importance of informed oral care decisions and ongoing investigations, this vital research works towards ensuring everyone can achieve a brighter, healthier smile.

Purpose To evaluate changes in toothbrushing behavior and plaque removal performance with usage of a next generation oscillating-rotating electric toothbrush (NG-OR).Methods This exploratory clinical study had a two-treatment, three-period, single-group, sequential design. Generally healthy adults with a screening whole mouth mean Turesky modified Quigley-Hein Plaque Index (TQHPI) score of at least 1.75 on a 0-5 scale and who were primarily OR brush users were enrolled. Participants used each OR toothbrush in A-B-B order, where a currently marketed OR brush with a traditional mechanical drive system (T-OR) was used in period A and the NG-OR brush with a linear magnetic drive was used in period B. At Visit 1, qualifying participants brushed on-site with T-OR. After a 48h washout, participants returned for Visit 2 and brushed on-site with NG-OR. Participants then used NG-OR for 1 week, twice daily, at home and returned for Visit 3 to brush on-site with NG-OR again. For all on-site brushings, participants were instructed to brush for 2min without interactive features. Each toothbrush was tagged with a transmitter chip connected to a Motion Tracking System to record movements of the toothbrush and participant using infrared light transmission to determine Isochronicity (brushing time uniformly distributed across the dentition). Plaque was measured using TQHPI. Primary variables were Isochronicity and TQHPl whole mouth mean plaque reduction (pre-brushing minus post brushing).Results Overall, 41 participants enrolled and received treatment; 40 completed the trial. NG-OR showed significantly greater Isochronicity after a single brushing (p=0.043) and after a 1-week at-home use (p=0.001) versus T-OR. NG-OR showed 41% greater whole mouth plaque removal than T-OR (p<0.001) after a single brushing. Plaque reduction by region/surface was consistent with whole mouth results.Conclusion The NG-OR brush showed greater brushing uniformity and plaque removal versus the T-OR brush.

Purpose: This 6-month study compared the effects of a smart-connected oscillating-rotating (O-R) electric rechargeable toothbrush with micro-vibrations with those of a marketed smart-connected sonic rechargeable toothbrush for the reduction of gingivitis and plaque. Methods: In this single-center, examiner-blind, two-treatment, open-label, parallel-group, randomized study, 110 adult subjects with evidence of gingivitis and plaque were randomized to use either the O-R brush (Oral-B iO) or the sonic brush (Philips Sonicare DiamondClean). Both groups were instructed to brush twice daily with a standard sodium fluoride dentifrice. Gingivitis and plaque were assessed at baseline, week 1, and week 24 using the Modified Gingival Index (MGI), Gingival Bleeding Index (GBI), and the Rustogi Modification of the Navy Plaque Index (RMNPI). Designation of gingivitis case status as "healthy" or "not healthy" was made according to the World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Results: A significantly greater percentage of subjects in the O-R brush group versus the sonic brush group transitioned from "not healthy" to "healthy" gingivitis case status at week 24 (96.4% vs. 81.8%; P=0.029). The O-R toothbrush produced a significantly greater reduction in adjusted mean MGI score, adjusted mean GBI score, and adjusted mean number of bleeding sites than did the sonic brush (week 24, by 32.6% for MGI score, by 23.7% for GBI score, and by 26.1% for number of bleeding sites, P<0.001). After a single use on day 1, plaque removal was statistically significantly greater for the O-R brush compared to the sonic brush (P<0.001); by week 24, the O-R brush demonstrated greater reductions in whole mouth plaque (24.6%), gingival margin plaque (61.9%) and approximal region plaque 25.8% (P <= 0.007 for all) compared to the sonic brush.

Dental plaque, a bacterial biofilm constantly forming on surfaces within the mouth, is responsible for dental caries and periodontal diseases.¹ When soft dental plaque is not removed, the dental plaque may develop into calculus (hardened plaque) under or above the gumline. The presence of plaque and calculus can irritate the gingiva (or simply, the gums), leading to the gingival inflammation called gingivitis.^2,3 The common symptoms of gingivitis include swollen, bleeding, and receding gingiva. Gingivitis is one of the most common oral diseases worldwide, and around 56% of adults in the United States have mild to severe gingivitis.⁴ If gingivitis is left untreated, gingivitis can advance to periodontitis, tooth loss, and other severe oral diseases.

Many adolescents have poor plaque control and sub-optimal toothbrushing behavior. Therefore, we compared the efficacy of an interactive power toothbrush (IPT) to a manual toothbrush (MT) for reducing dental plaque and improving toothbrushing compliance. In this randomized, parallel single-blind clinical study, adolescents brushed twice daily with either a MT (Oral-B® Indicator soft manual toothbrush) or an IPT (Oral-B® ProfessionalCare 6000 with Bluetooth). Subjects brushed for 2 min, plus an additional 10 s for each ‘Focus Care Area’. At screening and Week 2, afternoon pre-brushing plaque was assessed via the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI), and supervised brushing duration was measured. Sixty subjects were randomized; 98% completed. At Week 2, the mean reduction in whole mouth plaque relative to baseline was 34% (p < 0.001) for the IPT versus 1.7% (p = 0.231) for the MT. For Focus Care Areas, the IPT yielded a 38.1% mean TMQHPI reduction (p < 0.001) versus 6.2% for the MT (p < 0.001). Mean brushing time versus baseline increased 34 s in the IPT group (p < 0.001) while remaining flat in the MT group (p = 1.0). Over 2 weeks, adolescents using an IPT experienced superior plaque reduction and increased overall brushing time versus those using a MT. This trial was retrospectively registered ( ISRCTN10112852 ) on the 18th, June 2018.

Abstract:  Background:  A cleansing baby wipe with sufficient pH buffering capacity may help to restore the pH balance of skin following exposure to urine and feces in the diaper environment and maintain skin health.Objective:  To evaluate the skin effects of a novel baby wipe formulation with increased pH buffering.Subjects and Methods:  A series of clinical studies was designed and conducted to evaluate the skin effects of the new baby wipe, including a 21‐day cumulative skin irritation patch study in adults (n = 31), a 4‐week study in babies with medically confirmed atopic dermatitis (n = 32), a 2‐week study comparing skin pH of babies (n = 15) following use of wipes compared with water and wash cloth, a series of clinical skin pH measurements following fecal exposure and subsequent cleaning with different products (n = 50) and a study evaluating comfort of product application on irritated skin (n = 31).Results:  The wipes formulation was well‐tolerated, even in babies with atopic dermatitis, and was more comfortable versus water and washcloth. Increased buffering capacity of a wet wipes lotion helps to maintain a physiologically balanced skin pH value in the diaper region.

Abstract:  The skin of the diaper area has special needs for protection from the irritating effects of urine and feces and prevention of diaper dermatitis. These needs include products such as diapers that absorb the excreta, as well as products for cleansing and conditioning the skin. A number of factors play a role in development of diaper dermatitis, including prolonged exposure to excreta, alterations in skin pH or increased hydration, and changes in skin microbial flora. Recent decades have seen great improvements in our understanding of these factors and our ability to develop new and better products to protect baby skin. Better diaper designs and the development of pH‐buffered baby wipes have improved the care of skin in the diaper area. Continuing research offers the promise of new products with additional benefits for caregivers and infants.