The Effect of Changing the Toothbrush on the Marginal Gingiva Microcirculation in the Adolescent Population-A Laser Doppler Flowmetry Assessment

Abstract

It is well-known that proper tooth brushing has the effect of stimulating microcirculation in a healthy gingiva. The aim of this study was to evaluate the microcirculation dynamics at the level of healthy marginal gingiva in adolescents after changing their toothbrush. Three evaluation instruments were employed to assess and quantify the effects on the marginal gingiva: the periodontal probing depth (PD), gingival index (GI) and laser Doppler flowmetry (LDF). A total of 12 adolescents, aged between 15 and 20, were enrolled in the study, resulting in a total of 72 frontal upper teeth for PD and GI and 48 gingival interdental sites for LDF assessment. For each measurement, the pulp blood flow signal was recorded for 1 min and represented as a pulsatory signal. Data were collected in four moments: before the toothbrush changed and 24 h, 7 days and 14 days after. For the statistical analysis, the nonparametric Friedman test was applied for comparisons between more than two pair numeric series and for comparisons between two sets of pair values without Gaussian distribution, the Wilcoxon signed-rank test was applied. The paired t test was used for two sets of normally distributed paired values. The results showed that using a new toothbrush in the adolescent population with healthy gingiva can induce statistically significant increases in gingival blood flow, which remain at a high level even at two weeks. The GI also increases significantly at 7 days and 14 days, while the periodontal PD does not change significantly.

Keywords: gingival blood flow; gingival index; laser Doppler flowmetry; periodontal probing depth.

Figure 1

The sites for assessment of marginal gingival microcirculation using laser Doppler flowmetry are indicated by blue arrows.

Figure 2

The probe holder, used for positioning the LDF probe (mucosal view).

Figure 3

Laser Doppler gingival signal for 12–13 interdental papilla: (a) initial and (b) 24 h; (c) 7 days and (d) 14 days after using a new toothbrush. The pulsatory signal is shown in the upper window.

Figure 3

Laser Doppler gingival signal for 12–13 interdental papilla: (a) initial and (b) 24 h; (c) 7 days and (d) 14 days after using a new toothbrush. The pulsatory signal is shown in the upper window.

Figure 3

Laser Doppler gingival signal for 12–13 interdental papilla: (a) initial and (b) 24 h; (c) 7 days and (d) 14 days after using a new toothbrush. The pulsatory signal is shown in the upper window.

Figure 4

Comparative representation of the mean gingival blood flow in the four evaluation moments considered in the study.