Objective: These studies compare the effectiveness of a newly-designed manual toothbrush, with a cleaning implement on the back of the toothbrush head, to the leading manual toothbrush on desquamated epithelial cells (DEC), oral H₂S-forming tongue bacteria (OH-TB) and volatile sulfur compounds(VSC). Materials and Methods: Healthy adult subjects took part in three randomized, cross-over studies. After baseline sampling, subjects brushed their teeth for 1-min with the assigned toothbrush. Subjects using the new manual toothbrush also cleaned their tongue with the implement on the back of the toothbrush head for 10 seconds. For DEC, thirty minutes after brushing, subjects rinsed with 10 milliliters of sterile water for 10 seconds. Collected samples were evaluated in a colorimetric assay to measure the level of desquamated epithelial cells found in the rinse. For OH-TB, right and left sides of the tongue were swabbed at baseline and 2 hours, respectively, after brushing. Collected tongue samples were serially diluted in sterile water and triple plated onto lead acetate agar. After 72-hour incubation, the dark pigmented colonies were counted. For VSC, the evening after baseline morning breath sampling, subjects brushed their teeth before going to bed, and then returned for overnight breath sampling. Breath VSC were evaluated with a gas chromatograph and levels were expressed as parts per billion (ppb) in mouth air. Results: The new manual toothbrush reduced DEC, OH-TB and VSC 74, 84 and 63%, respectively, versus baseline. Respective reductions were 45, 64 and 16% for the leading manual toothbrush. The new manual toothbrush was significantly better than the leading manual toothbrush in reducing DEC, OH-TB and VSC. Conclusion: The clinical results indicate that a newly designed manual toothbrush with a cleaning implement on the back of the toothbrush head is significantly more effective than the leading manual toothbrush in reducing DEC, OH-TB and VSC.

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