Toothbrushing is an established health

No advantage of daily powered toothbrushing as compared to daily manual toothbrushing was seen with respect to oral hygiene or clinical parameters. The capability to achieve oral cleanliness was low, irrespective of the type of electric toothbrush bulk

  toothbrush under consideration. Additional effort is thus needed to improve this capability. Toothbrushing is an established health behavior aiming to remove dental plaque and thereby to maintain oral health [1]. A representative study shows that in Germany self-reported oral hygiene behavior complies with general recommendations by dental professionals regarding the frequency and duration of daily  , the prevalence of gingivitis and periodontitis is considerable in Germany and   One reason for this observed discrepancy between regularly performed oral hygiene and high prevalence of periodontal disease could be that patients are lacking the appropriate skills to remove plaque. Indeed, a recent series of studies has shown that dental laypeople (i.e. people without any dental background) hardly ever manage to clean more than 30–40% of their gingival margins by means of manual toothbrushing even when they perform to the best of their abilities [4,5,6,7,8,9,10]. On the other side, dental professionals achieve oral cleanliness at more than 90% of their gingival margins [11]. This result indicates that effective manual toothbrushing is possible but that dental

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