Comparison of Periodontal Status of Adult Individuals Using Charcoal and Regular Nylon Toothbrushes in a Nigerian Health Facility

Amuh Veronica Obianuju; Ehizele Adebola; Ezebor Rebecca

doi:doi:10.11648/j.cmr.20251401.11

Research Article |

| Peer-Reviewed

Comparison of Periodontal Status of Adult Individuals Using Charcoal and Regular Nylon Toothbrushes in a Nigerian Health Facility

Amuh Veronica Obianuju^*

, Ehizele Adebola

, Ezebor Rebecca

Published in Clinical Medicine Research (Volume 14, Issue 1)

Received: 23 January 2025 Accepted: 7 February 2025 Published: 24 February 2025

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

The high prevalence of periodontal disease in adolescents, adults, and older individuals makes it a public health concern. Although studies have been reported on the efficacy of charcoal-infused versus Nylon toothbrushes on periodontal health, there appears to be a lack of documented reports. This study compared individuals' periodontal health using a charcoal-infused and a regular nylon bristle toothbrush. This randomized clinical crossover study recruited all consecutive participants who presented to the Department of Periodontics at a tertiary facility for scaling, between May 2022 to April 2023. Each participant made use of each toothbrush; Charcoal-infused and Nylon toothbrush. Participants were instructed to brush with either toothbrush and the same fluoride toothpaste, morning and evening after meals, for three minutes and with the modified Bass technique. They were recalled after three weeks for assessment and the PI, GI, and CPITN were recorded at baseline and after three weeks of use of toothbrushes. After six months of washout (using whatever individual was used to), the toothbrush was exchanged, and the same procedure and assessments were done. Data collected were Biodata (age, sex, marital status, occupation, education, and ethnic group) and records of PI, GI, and CPITN values. A level of significance was set at p<0.05. All analysis was done with SPSS software version 26, (IBM, Armonk, New York, US). A total of twenty - two adults with a mean age of 32.82±12.19 years were recruited in this study. There was an improvement in periodontal status as all the participants had healthy gingivae at the end of the study. There was a significant reduction of the mean CPITN values for charcoal (p=0.0001) and Nylon (p= 0.001) over three weeks. However, there was no statistically significant difference in PI, GI, and CPITN (p =0.757, p =0.806, p =0.391, and p =0.1) respectively. The charcoal-infused toothbrush was not better than the Nylon bristle toothbrush in maintaining the periodontal status of participants in this study over three weeks. However, the periodontal status of participants was positively impacted.

Published in	Clinical Medicine Research (Volume 14, Issue 1)
DOI	10.11648/j.cmr.20251401.11
Page(s)	1-11
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Charcoal/Nylon, Toothbrush, Periodontal Status

1. Introduction

Periodontal health is related to oral health and general well-being

[1]

. Periodontitis is the most common chronic inflammatory disease seen in humans, with considerable impacts on individuals and society

[2]

. People with untreated periodontitis which is an oral disease, result in preventable pain, infection, and reduced quality of life, as well as missed school and productivity losses. Poor oral health may be associated with heart disease, stroke, diabetes, pneumonia, and other respiratory diseases. Good oral health is also necessary for healthy aging, playing a crucial role in nutrition, employment, self-esteem, and continued social interaction. It is therefore important to preserve periodontal and oral health status. Supragingival plaque removal is considered to be of utmost importance in the decline of the prevalence of caries, gingivitis, and periodontitis

[3]

Periodontal health and oral health status can be maintained with proper plaque removal measures since the primary aetiologic factor of periodontal diseases is bacterial plaque

[4, 5]

. Plaque removal measures include the use of manual toothbrushes and dentifrices, tooth floss, interdental brushes, and mouth rinses. The efficacy of mechanical plaque control with a manual toothbrush depends on user dexterity, technique, force, duration, and frequency during brushing

[5]

The choice of an individual’s toothbrush design is determined by his oral health needs. The toothbrush design is dependent upon toothbrush head size, shank angulation, bristle material, and arrangement. The brushing plane of toothbrushes is determined by the bristle length and angulation

[5]

. The nylon bristle toothbrush is commonly used with varying bristle diameter, length, taper, and arrangement within tuft slots in the head of the toothbrush

[5]

The bending, splaying, and flaring of worn bristles possibly affect their plaque removal efficacy requiring the replacement of toothbrushes

[6]

The blending of charcoal into nylon bristles can reduce halitosis, reduce plaque, and also kill bacteria

[7]

. Bristles of charcoal toothbrushes are black and are prepared by blending binchotan charcoal into nylon bristles

[8]

. When Charcoal is exposed to high temperatures often in combination with gases such as oxygen during manufacturing, it becomes activated. Charcoal when activated has a high absorptive capacity

[7]

. When a form of carbon is treated it essentially becomes activated charcoal. The treatment involves the removal of water and other volatile constituents from carbon-based materials, such as bamboo, wood, or coconut husk and shell

[8]

, to make the surface of its particles porous. The pores act like magnets for other particles like dirt and oil which it absorbs, allowing all of the unwelcome substances to be swept away when the charcoal is washed off

[8]

In theory, charcoal binds to everything in its path like stains, tartar, bacteria, viruses, and even the tonsils

[7]

. Extrinsic stains slowly accumulate on the outermost part of the tooth structure, the enamel. These gradually developing stains are due to certain substances in caffeine, wine, smoking, and some stain-producing foods

[8]

. Extrinsic stains are the secondary causative factor for periodontal disease

[8]

. The more the stain, the more plaque, the more the disease, and the poorer the oral hygiene status.

Activated charcoal helps to push up the pH level of the oral cavity primarily because it can bind with acidic components in plaque and results in their accelerated removal from the oral cavity. Nylon bristles toothbrush is the most commercially available toothbrush manufactured

[9]

. Nylon bristles were copies of natural bristles in length and thickness initially

[9]

. They were stiffer than natural bristles of similar diameters, and did not have the hollow stem of natural bristles, and thus did not absorb water

[9]

. However, compared to natural bristles, nylon filaments have additional advantages; they can be in various uniform diameters and shapes; and end-rounded to be gentle on gingival tissues during brushing

[9]

. However, the charcoal blended into nylon bristles toothbrush gives an added advantage of binding to the acidic components of plaque and improving plaque removal. Therefore, it will be necessary to compare the effectiveness of charcoal and nylon toothbrushes in maintaining periodontal and oral health status. Thus, activated charcoal helps to remove plaque and results in relieving halitosis

[7]

Tooth brushing is the most widely used method for plaque control, and a wide variety of toothbrushes are commercially available. Studies comparing the efficacy of available toothbrushes are scarce

[10]

.In a study among dental practitioners, there was also low awareness and knowledge of charcoal-based products

[8]

. The use of a charcoal toothbrush was recommended in a study, as it demonstrated better plaque removal efﬁcacy as compared to plain nylon bristle

[11]

.Thus, it is necessary to have an efficient plaque removal measure for maintaining both periodontal and oral health status, especially in our setting.

Traditionally our forefathers used charcoal which aided in good dental plaque control; however, studies have not been done to test their effectiveness, efficacy, and efficiency in our setting. A major point raised by a previous study was that charcoal-infused bristle toothbrushes had better plaque control efficacy than regular nylon toothbrushes among dental students

[11]

. Thus in areas such as ours, it will be necessary to know the plaque control effectiveness by comparing the Charcoal-infused bristles toothbrush versus the regular Nylon toothbrush; to provide alternative oral hygiene methods to persons who may be aware of charcoal used for oral hygiene practice however unsure of its effect and safety. Also, a paucity of studies has been reported in Nigeria to demonstrate the efficacy of charcoal-infused toothbrushes compared to nylon bristle toothbrushes in maintaining periodontal health status. The aim therefore is to compare the periodontal health of persons using charcoal-infused toothbrushes with those using regular nylon bristles.

2. Materials and Methods

Following ethical approval (ADM/E/A/VOL, VII/14831070), a randomized clinical crossover study was conducted between May 2021 to May 2022 among adult participants who presented to the Periodontics clinic, of a Nigerian Tertiary health facility. Individuals who met the inclusion criteria, presented for dental treatment, and gave their consent, were recruited into the study. They used both the regular nylon toothbrushes and the new charcoal-infused bristle toothbrushes.

Inclusion criteria included Adults 18 years and above and without co-morbidities. (Hypertension, Diabetes). Subjects without habits and conditions that cause reduced saliva. Subjects not wearing orthodontic or prosthetic appliances. Subjects without crowding. Subjects who were not on antimicrobials or analgesics. Subjects who did not report tobacco use in any form. Subjects without mouth breathing and occlusal parafunction.

This clinical study was registered with the Pan African Clinical Trial Registry (www.pactr.org) database, with an identification number; PACTR202305892616028.

A sample size of 22 was calculated with the Siyasinghe and Sooriyarachichi formula

[40]

(n=

\frac{{(Ƶ_{\frac{α}{2}} + Ƶ_{ß})}^{2} {σ_{m}}^{2}}{2 {(μ_{1} - μ_{2})}^{2}}

)

The data collected were age, gender, occupation, level of education, and marital status. Other data collected were recorded on the proforma provided; on the assessment of Plaque, Oral Hygiene status, gingival status, and Community Periodontal Index for Treatment Needs.

Oral Examination was done with a Dental mirror and an Explorer.

A Pre-test was also conducted. This involved 4 participants (18% of the sample size) that were not part of the study; before the commencement of the study. Two of the participants used charcoal toothbrushes and the other two used regular nylon toothbrushes to assess their adherence to the oral hygiene instructions with the same frequency, timing, and technique following the use of the toothbrush.

Participants were selected using a systematic sampling technique, by choosing the second person with a sampling interval (Population/ sample size=30/15) of two, after random sampling of the first sample fulfilling the selection criteria as they present. A clinical examination was performed on the dental chair. Assessments were done for the Plaque, Oral hygiene, and Periodontal status with the use of the Turesky-modified Quigley Hein plaque index, Simplified Oral hygiene index, gingival index, and the community periodontal index of treatment needs (CPITN) Index. Oral hygiene instructions; were given on the frequency, sequence, and timing of tooth brushing. The standard brushing instructions involve the use of either a Charcoal-infused or regular Nylon toothbrush with a Modified Bass brushing technique for three minutes twice a day after meals (morning and evening), and brushing each quadrant six times. They also used fluoride-containing toothpaste provided for them. Participants were also discouraged from using other mechanical or chemical plaque control methods. They had oral prophylaxis. Two participants were assessed in a day, thrice a week. A ballot form of random sampling: using sealed envelopes was given to participants to determine what toothbrush to use first.

2.1. Introductory and First Appointment

Initial oral prophylaxis was done to take the plaque score to zero. There was a recall of one day without brushing to allow the build of plaque for the baseline, and a record of the assessments for PI, OHI-S, CPITN, and GI. Eleven participants had one charcoal-infused bristle toothbrush each, while the other eleven were given one nylon bristle toothbrush each, for use in three weeks.

2.2. Second Appointment

Participants’ plaque index, Simplified Oral hygiene index, Gingival index, and the community periodontal index of treatment needs (CPITN) Index, were assessed and the records were documented. The first toothbrush was retrieved, and the oral hygiene instruction re-emphasized. Participants were encouraged to use their previous plaque control method and return after six months.

2.3. Crossover and Third Appointment

There was a washout period of six months, and participants came for a third appointment.

A second oral prophylaxis to standardize the patient (take the plaque score to zero) was carried out. There was a recall of one day without brushing to allow the build of plaque for the baseline of the second phase of intervention and a record of the assessments of PI, OHI-S, CPITN, and GI was taken. The toothbrushes (Charcoal-infused, regular Nylon) were given for another three weeks, such that those who used charcoal in the first phase got the nylon toothbrush. Oral hygiene instructions were re-emphasized.

2.4. Fourth Appointment

The assessment was done using the Plaque index, GI, OHI-S, and CPITN after three weeks, and measurements were recorded.

Study participants were assessed for baseline parameters, plaque levels, oral hygiene, and periodontal status before and after three weeks of using the different experimental toothbrushes.

Both descriptive and inferential statistics were performed. In descriptive statistics, the categorical data were presented as frequency and percentages while the continuous data were summarized as range, means and standard deviation. In the inferential statistics, of group differences in variables, such as an independent t-test, paired t-test, and ANOVA (Analysis of Variance test) was employed. The level of significance was set at p<0.05. All data was analyzed using SPSS software version 26 (IBM, Armonk, New York, US).

3. Results

A total of 22 participants were recruited for this crossover study. There were more females (13, 59.1%) than males (9, 40.9%) in the study. The mean age of the study participants was 32.82±12.19 years. There was a statistically significant difference in the age distribution between the two toothbrush sequence categories (p=0.006). There was also a statistically significant difference in marital status (p=0.010) and occupational level (p = 0.009). However, these significant differences will not affect the study outcomes as this was a crossover study, where all participants received both interventions and served as their controls.

There was a considerable reduction in the level of gingivitis, as all the participants had healthy gingivae at the end of the study. There was a significant reduction of the mean CPITN values for charcoal (p=0.0001) and Nylon (p= 0.001) over three weeks. Both toothbrushes impacted the periodontal status in improving oral health. However, there was no statistically significant difference in GI, and CPITN (p =0.391, and p =0.1 respectively) in comparison to either toothbrush after the three weeks of use.

4. Discussion

Periodontal diseases are prevalent in developed and developing countries and affect about 20-50% of the global population

[39]

. This high prevalence of periodontal diseases, in adolescents, adults, and older individuals makes it a public health concern

[38]

. Several studies on the Prevalence of periodontal diseases in Nigeria have been on the increase with a varied rate from 15% to about 90%

[41, 44-49]

.Periodontal diseases have been known to have a considerable impact on our society

[2]

, and if left untreated cause reduced quality of life, missed school attendance, and productivity losses. It is, therefore, necessary to preserve periodontal and oral health status using proper plaque removal measures

[5]

, like nylon bristle or charcoal-infused toothbrushes. It has also been established that the primary aetiologic factor of periodontal disease is bacterial plaque

[4]	Petersen PE, Bourgeois D, and Ogawa H, et., al. The global burden of oral diseases and risks to oral health. Bull World Health Organ 2005; 83: 661–669 https://doi.org/10.1590/S0042-96862005000900011 View Article
[5]	Genco RJ. Current view of risk factors for periodontal diseases. J. Periodontol 1996; 67(Suppl.): 1041–1049 https://doi.org/10.1902/jop.1996.67.10.1041 View Article
[13]	Ruby J, Barbeau J. The buccale puzzle: the symbiotic nature of endogenous infections of the oral cavity. Canadian Journal of Infectious Diseases 2002; 13(1): 34–41. https://doi.org/10.1155/2002/492656 View Article
[14]	Berezow AB, Darveau RP. Microbial shift and periodontitis. Periodontol 2000. 2011; 55(1): 36–47. https://doi.org/10.1111/j.1600-0757.2010.00350.x View Article
[15]	AlJehani YA. Risk factors of periodontal disease: review of the literature. Int J Dent 2014; 2014: 182513. https://doi.org/10.1155/2014/182513 View Article
[16]	Velsko IM., Fellows Yates JA, Aron F, et al. Microbial differences between dental plaque and historic dental calculus are related to the oral biofilm maturation stage. Microbiome 2019; 7: 102. https://doi.org/10.1186/s40168-019-0717-3 View Article
[17]	Marsh PD. Dental plaque as a microbial biofilm. Caries Res 2004; 38: 204–211. https://doi.org/10.1186/1472-6831-6-S1-S14 View Article
[18]	Kolenbrander PE, Andersen RN, Kazmerak KM, Palmer RJ. Coaggregation and adhesion in oral biofilms. In: Allison DG, Gilbert P, Lappin-Scott HM, Wilson M, editor. Community structure and co-operation in biofilms. Cambridge, Cambridge University Press, Society for General Microbiology Symposium 59 2000; 65–85.
[19]	Patil V, N M. S. Concrescence and Periodontitis: A Case Report. The Internet Journal of Dental Science 2009; 8: 2. https://doi.org/10.4103/0972-124X.115647 View Article
[20]	Valkenburg C, Weijden F, Slot D. Plaque control and reduction of gingivitis: The evidence for dentifrices. Periodontol 2000 2019; 79(1): 221-232. https://doi.org/10.1111/prd.12257 View Article
[21]	Rowe DJ, Weyant R. Powered toothbrushes may reduce plaque and gingivitis at least as effectively as manual toothbrushing. J Evid Based Dent Pract 2005; 5(3): 139-140. https://doi.org/10.1016/j.jebdp.2005.06.007 View Article
[22]	Davidovich E, Grenier J, and Zini A. Factors Associated with Dental Plaque, Gingivitis, and Caries in a Pediatric Population: A Records-Based Cross-Sectional Study. Int J Environ Res Public Health 2020; 17(22): 8595. https://doi.org/10.3390/ijerph17228595 View Article
[23]	Gillette WB, Van House RL. Ill effects of improper oral hygiene procedure. J Am Dent Assoc 1980; 101(3): 476-480. https://doi.org/10.14219/jada.archive.1980.0295 View Article
[24]	Jafer M, Patil S, and Hosmani J, et al. Chemical Plaque Control Strategies in the Prevention of Biofilm-associated Oral Diseases. J Contemp Dent Pract 2016; 17(4): 337-343. https://doi.org/10.5005/jp-journals-10024-1851 View Article
[25]	Thosar N. et., al. Changing Trends in Oral Hygiene and Plaque Control in Children. J Dent & Oral Care 2016; 3(1): 1-5. https://doi.org/10.15436/2379-1705.15.026 View Article
[26]	Sugano N. Biological plaque control: novel therapeutic approach to periodontal disease. J Oral Sci 2012; 54(1): 1-5. https://doi.org/10.2334/josnusd.54.1 View Article
[27]	Hammerman C, Bin-Nun A, Kaplan M. Safety of probiotics: comparison of two popular strains. BMJ 2006; 333(7576): 1006-1008. https://doi.org/10.1136/bmj.39010.630799.BE View Article
[28]	Thakur A, Ganeshpurkar A, Jaiswal A. Charcoal in Dentistry. Natural Oral Care in Dental Therapy, 2020; 197–209. https://doi.org/10.1002/9781119618973.ch13 View Article
[29]	Fattai RK, Risovannaya ON, Comparative Evaluation of the Major Groups of manual toothbrush efficiency and their effect on oral hygiene status. Archive Euromedica.2019; 9: https://doi.org/10.35630/2199-885X/2019/9/1/155 View Article
[30]	Raggio DP, Braga MM, Rodrigues JA, Freitas PM, et al. Reliability and discriminatory power of methods for dental plaque quantification. J Appl Oral Sci. 2010; 18(2): 186-193. https://doi.org/10.1590/S1678-77572010000200014 View Article
[31]	Han SY, Kim BR, Ko HY, Kwon HK, Kim BI. Validity and reliability of autofluorescence-based quantification method of dental plaque. Photodiagnosis Photodyn Ther. 2015; 12(4): 587-591. https://doi.org/10.1016/j.pdpdt.2015.10.003 View Article
[32]	Maduakor S, Lauverjat Y, Cadot S, et al, Application of Community Periodontal Index Treatment Need (CPITN) In Enugu (Nigeria). Study of Secondary School Students Aged Between 12-18 Years 2000; Odontostomatol Trop 82(138), 110.
[33]	Aspalli S, Shetty VS, Devarathnamma MV, Nagappa G, Archana D, Parab P. Evaluation of the antiplaque and antigingivitis effect of herbal mouthwash in the treatment of plaque-induced gingivitis: A randomized, clinical trial. J Indian Soc Periodontol. 2014 Jan; 18(1): 48-52. https://doi.org/10.4103/0972-124X.128208 View Article
[34]	Wu P, Tu K, Lu L, Chang H, Lu, K. Quantitative analysis of Miller mobility index for the diagnosis of moderate to severe periodontitis - A cross-sectional study. Journal of Dental Sciences. 2018; 13(1), 43-47. https://doi.org/10.1016/j.jds.2017.11.001 View Article

[4, 5, 13-34]

. Consequently, this study aims to compare the effectiveness of charcoal and nylon toothbrushes in maintaining oral health and periodontal states.

A total of twenty-two participants participated in this study with 100% participation. This study was conducted as a cross-over study so that the participants acted as their controls; their technique, duration, sequence, and frequency in brushing remained similar during both phases with the use of the toothbrushes

[7]

. The participants were blinded to the interventional toothbrushes (Charcoal-infused and regular Nylon) given to them using sealed envelopes at the different phases of the study to remove the Hawthorne effect (knowledge of an intervention influencing the outcome) experienced in a study with a single toothbrush use

[49]

This study was carried out with each toothbrush, used over three weeks during each phase of the study

[48]

, with assessments for PI, OHI-S, CPITN, and GI performed at baseline and three weeks from baseline for both phases of the intervention. The toothbrush was used for three weeks to utilize the utmost efficacy of the toothbrush as some toothbrushes experience wear by one month from commencement of use.

Oral hygiene instructions; were given to all participants to adhere to a similar technique (modified Bass), sequence (six times on each quadrant), duration (3 minutes), and frequency morning and evening every day) to subject both toothbrushes to similar patterns of use

[12]

. A pre-test comprising four volunteer participants, was carried out to assess their adherence to the oral hygiene instructions with the same frequency, timing, and technique; in the use of the toothbrush. The outcome was satisfactory, and further educated them; on their oral health promotion. Participants were monitored with phone calls to remind them of the instructions and their dates of appointments.

All participants were given oral prophylaxis at the baseline and after the washout period of six months to standardize them. Then participants were given a day recall to allow for the build of plaque without brushing at night, and assessments for the baseline were done. At the end of the three weeks for each phase of the study, assessments of the PI, OHI-S, CPITN, and GI were also done.

The modified Bass technique was chosen for this study as the bristle tips removed plaque from the cervical area of teeth along the free gingival margin and facilitated intra-sulcular brushing without causing abrasive trauma to the gingiva

[49]

More females (59.1%) were found to be present in this study, and this was also similar (72%) in the study by Kini et al, who studied the plaque removal efficacy and bristle wear between charcoal-infused and nylon bristle toothbrushes

[12]

. This predominance of females could be attributed to the better oral health-seeking behavior that is among them

[35, 50]

. Although there was no significant difference among the genders in the toothbrush categories in this study, there was a significant difference among genders in PI, OHI-S, and brushing frequency in a study by Kolawole et al, in western Nigeria

[47]

and another study in India

[36]

. Similar to this study, there was no significant difference between charcoal based and non-charcoal-based toothbrushes in maintaining oral hygiene in other studies

[37]	Prusty AK, Sharma S, Malhotra S. Comparative efficacy of different varieties of toothbrushes in plaque control: A 12-week clinical trial. Indian J Dent Res [serial online] 2021; 32: 372-9. https://doi.org/10.4103/ijdr.IJDR_179_20 View Article
[51]	Versteeg PA, Rosema NAM, Timmerman MF, et al. Evaluation of two soft manual toothbrushes with different filament designs about gingival abrasion and plaque removal efficacy. Int J Dent Hygiene. 2008; 6(3): 166-173. https://doi.org/10.1111/j.1601-5037.2008.00298.x View Article
[52]	Bamigboye, O., & Akande, T. M. Oral hygiene status of students in selected secondary schools in Osogbo, Nigeria. Nig Med Pract, 2007; 51, 71-75. https://doi.org/10.4314/nmp.v51i4.28845 View Article
[53]	Santhosh K, Jyothi T, Prabu D, Suhas K. Socio-behavioral variables affecting oral hygiene and periodontal status of 12-year-old schoolchildren of Udaipur district. Odonto-stomatologie Tropicale = Tropical Dental Journal. 2013 Mar; 36(141): 27-33.
[54]	Hedge S, Kakade AA, Rajesh KS, et al. Evaluation of plaque removal efficacy of two manual toothbrushes with different textures: a comparative analysis. Journal of Oral Health Research. 2011; 2(3): 84-90. https://doi.org/10.4034/PBOCI.2019.191.05 View Article
[55]	Somnathe S, Gothane D, Chapade A et al. Comparison of plaque removal efficacy of toothbrush with bristle containing Neem and Charcoal for maintaining oral hygiene. A Randomized Clinical Trial. JCDR 2022; 16(10): 2031-2034). https://doi.org/10.7860/JCDR/2022/55416.17036 View Article
[56]	Ballini A, Di Cosola M, Saini R, Benincasa C, Aiello E, Marrell, B., et al. A Comparison of Manual Nylon Bristle Toothbrushes versus Thermoplastic Elastomer Toothbrushes in Terms of Cleaning Efficacy and the Biological Potential Role on Gingival Health. Appl. Sci. 2021; 11: 7180. https://doi.org/10.3390/app11167180 View Article
[57]	Sharma NC, Qaqish JG, Galustians HJ, et., al. A 3-month comparative investigation of the safety and efficacy of a new toothbrush: results from two independent clinical studies. American Journal of Dentistry. 2000; 13: 27A-32.

[37, 51-57]

5. Conclusion

The charcoal-infused toothbrush was not better than the Nylon bristle toothbrush in maintaining the periodontal status of participants in this study over three weeks. Moreover, the periodontal status of participants in this study was positively impacted by the use of both interventional tools.

Limitation

The sample size included in the study is small.

Apart from the various advantages of Charcoal cited in the study, there are also a few disadvantages/adverse effects of using Charcoal toothbrushes.

Abbreviations

PI	Plaque Index
GI	Gingival Index
CPITN	Community Periodontal Index of Treatment Needs
US	United States of America
OHI-S	Simplified Oral Hygiene Index
ANOVA	Analysis of Variance Test

Acknowledgments

We wish to thank the patients whose information was used in this study and also all the consultants in the department for allowing us to recruit their patients.

Funding

The research was self-funded.

Data Availability Statement

The data are available on request from the corresponding author.

Conflicts of Interest

The authors declare no conflict of interest related to the study.

Appendix

Table 1. Socio-demographic Characteristics of the Study Participants.

Variable	Sequence (N=22)		Total	Statistic	P value
Variable	†N₁- C₂ (n=11)	C₁ - N₂ (n=11)	Total	Statistic	P value
Sex
Male	6 (54.5%)	3 (27.3%)	9 (40.9%)	Yates=0.752	0.386
Female	5 (45.5%)	8 (72.7%)	13 (59.1%)
Total	11 (100%)	11 (100%)	22 (100%)
Age Category (yrs.)
≤20	0 (0%)	4 (36.4%)	4 (18.2%)	Fishers=11.242	0.006*
21-30	1 (9.1%)	5 (45.5%)	6 (27.3%)
31-40	6 (54.5%)	1 (9.1%)	7 (31.8%)
≥41	4 (36.4%)	1 (9.1%)	5 (22.7%)
Total	11 (100%)	11 (100%)	22 (100%)
Mean Age	40.82±9.32	24.82±9.17	32.82±12.19	T=4.057	0.001*
Marital status
Single	2 (18.2%)	8 (72.7%)	10 (45.5%)	Yates=6.600	0.010*
Married	9 (81.8%)	3 (27.3%)	12 (54.5%)
Total	11 (100%)	11 (100%)	22 (100%)
Educational Level
Primary	1 (9.1%)	0 (0%)	1 (4.5%)	Fishers=2.062	0.476
Secondary	1 (9.1%)	0 (0%)	1 (4.5%)
Tertiary	9 (81.8%)	11 (100%)	20 (90.9%)
Total	11 (100%)	11 (100%)	22 (100%)
Ethnic group
Edo	5 (45.5%)	7 (63.6%)	12 (54.5%)	Fishers=4.529	0.200
Esan	2 (18.2%)	4 (36.4%)	6 (27.3%)
Igbo	1 (9.1%)	0 (0%)	1 (4.5%)
Others	3 (27.3%)	0 (0%)	3 (13.6%)
Total	11 (100%)	11 (100%)	22 (100%)
ISCO Occupational Classification
Level I	0 (0%)	6 (54.5%)	6 (27.3%)	Fishers=10.233	0.009
Level II	5 (45.5%)	1 (9.1%)	6 (27.3%)
Level III	4 (36.4%)	4 (36.4%)	8 (36.4%)
Level IV	2 (18.2%)	0 (0%)	2 (9.1%)
Total	11 (100%)	11 (100%)	22 (100%)

† N₁ - C₂= Nylon bristle (1st period) Charcoal-infused (2nd period) Group; C₁ - N₂= Charcoal-infused (1st period) then Nylon bristle (2nd period) Group. ISCO: International Standard Classification of Occupations

[41]

Table 2. Comparison of the GI P values in participants using Charcoal-infused toothbrushes and those using regular Nylon bristle toothbrushes.

GI Scores	Nylon n (%)	Charcoal n (%)	Total n (%)	P value
24 hours
0	4 (36.4)	4 (36.4)	8 (36.4)	0.023
1	5 (45.5)	7 (63.6)	12 (54.5)
2	2 (18.1)	0 (0.0)	2 (9.1)
3	0 (0.0)	0 (0.0)	0 (0.0)
3 weeks
0	9 (81.8)	7 (63.6)	16 (72.7)	0.015
1	2 (18.2)	4 (36.4)	6 (27.3)
24 hours
0	8 (72.7)	8 (72.7)	16 (72.7)	0.452
1	2 (18.2)	3 (27.3)	5 (22.8)
2	1 (9.1)	0 (0.0)	1 (4.5)
3 weeks
0	11 (100.0)	11 (100.0)	22 (100.0)	-------
Total	11 (100.0)	11 (100.0)	22 (100.0)

Table 3. Analysis of variance table to test for Carryover (treatment sequence) and Period effects on GI.

Source	Df	Type III SS	F value	P value
Sequence effect	1	0.117	1.099	0.301
Period	1	0.080	0.752	0.391
Error	39	4.140	-	-

Table 4. Intergroup and Intragroup Comparisons for GI.

GI Scores	Nylon n (%)	Charcoal n (%)	Total n (%)	P value
24 hours
0	4 (36.4)	4 (36.4)	8 (36.4)	0.023
1	5 (45.5)	7 (63.6)	12 (54.5)
2	2 (18.1)	0 (0.0)	2 (9.1)
3	0 (0.0)	0 (0.0)	0 (0.0)
3 weeks
0	9 (81.8)	7 (63.6)	16 (72.7)	0.015
1	2 (18.2)	4 (36.4)	6 (27.3)
24 hours
0	8 (72.7)	8 (72.7)	16 (72.7)	0.452
1	2 (18.2)	3 (27.3)	5 (22.8)
2	1 (9.1)	0 (0.0)	1 (4.5)
3 weeks
0	11 (100.0)	11 (100.0)	22 (100.0)	-------
Total	11 (100.0)	11 (100.0)	22 (100.0)

Table 5. CPITN P values in participants using Charcoal-infused toothbrushes and those using regular nylon bristle toothbrushes.

CPITN Scores	Nylon n (%)	Charcoal n (%)	Total n (%)	P value
24 hours
0	1 (9.2)	0 (0.0)	1 (4.5)	0.200
1	4 (36.1)	8 (72.7)	12 (54.5)
2	5 (45.5)	3 (27.3)	8 (36.4)
3	1 (9.2)	0 (0.0)	1 (4.5)
3 weeks
0	5 (45.4)	5 (45.4)	10 (45.5)	0.798
1	4 (36.4)	5 (45.4)	9 (40.9)
2	2 (18.2)	1 (9.1)	3 (13.6)
24 hours
0	6 (72.7)	4 (36.4)	10 (45.5)	0.311
1	1 (9.2)	0 (0.0)	1 (4.5)
2	4 (36.1)	6 (54.5)	10 (45.5)
3	0 (0.0)	1 (9.2)	1 (4.5)
3 weeks
0	10 (90.9)	7 (63.6)	17 (77.2)	0.162
1	1 (9.1)	2 (18.2)	3 (13.6)
2	0 (0.0)	2 (18.2)	2 (9.2)
Total	11 (100.0)	11 (100.0)	22 (100.0)

Download: Download full-size image

Figure 1. Flowchart of Study participants- Enrolment, allocation, intervention, follow-up, and data analysis of a crossover trial, with each serving as its control. (Modified from the CONSORT (Consolidated Standards of Reporting Trials) 2010 Statement

[42, 43]

Download: Download full-size image

Figure 2. The trend of GI in the Study groups.

Download: Download full-size image

Figure 3. The trend of CPITN in the study groups.

References

[1]	Fischer RG, Lira Junior R, Retamal-Valdes B, and Figueiredo LC, et al. Periodontal disease and its impact on general health in Latin America. Section V: Treatment of periodontitis. Braz Oral Res 2020; 9: 34 https://doi.org/10.1590/1807-3107bor-2020.vol34.0026
[2]	Peter Greaves Histopathology of Preclinical Toxicity Studies (Fourth Edition) 2012, Pages 325-431.
[3]	Chapple IL, Van der Weijden F, Doerfer C, Herrera D, Shapira L, and Polak D et al. Primary prevention of periodontitis: managing gingivitis. J Clin Periodontol 2015; 42 https://doi.org/10.1111/jcpe.12366
[4]	Petersen PE, Bourgeois D, and Ogawa H, et., al. The global burden of oral diseases and risks to oral health. Bull World Health Organ 2005; 83: 661–669 https://doi.org/10.1590/S0042-96862005000900011
[5]	Genco RJ. Current view of risk factors for periodontal diseases. J. Periodontol 1996; 67(Suppl.): 1041–1049 https://doi.org/10.1902/jop.1996.67.10.1041
[6]	Bergenholtz A, Gustafsson LB, Segerlund N, et al. The role of brushing technique and toothbrush design in plaque removal. Scand J Dent Res 1984; 92(4): 344-351. https://doi.org/10.1111/j.1600-07221984.tb00901.x
[7]	Tere´zhalmy GT, Biesbrock AR, Walters PA, et al. Clinical evaluation of brushing time and plaque removal potential of two manual toothbrushes. Int J Dent Hygiene. 2008; 6(4): 321- 327. https://doi.org/10.1111/j.1601-5037.2008.00327.x
[8]	Asra Sabir Hussain. Charcoal-Based Dental Products in Clinical Practice: An Update Am J Biomed Sci & Res 2019; 3(2). https://doi.org/10.34297/AJBSR.2019.03.000646
[9]	Yang K, Peng J, Srinivasakannan C, et al. Preparation of high surface area activated carbon from coconut shells using microwave heating. Bioresour Technol 2010; 101(15): 6163–6169. https://doi.org/10.1016/j.biortech.2010.03.001
[10]	Rosing CK, Cavagni J, and Eduardo J. Efficacy of two soft-bristle toothbrushes in plaque removal: a randomized controlled trial. Braz. Oral Res 2016; 30: 1. https://doi.org/10.1590/1807-3107BOR-2016.vol30.0134
[11]	Pertiwi U I et al. Surface changes of enamel after brushing with charcoal toothpaste. 2017 J. Phys.: Conf. Ser. 884: 012002. https://doi.org/10.1088/1742-6596/884/1/012002
[12]	Kini V, Yadav S, Rijhwani, J et al. Comparison of Plaque Removal and Wear between Charcoal-infused Bristle and Nylon Bristle Toothbrushes: A Randomized Clinical Crossover Study. The Journal of Contemporary Dental Practice 2019; 20: 377-384. https://doi.org/10.5005/jp-journals-10024-2525
[13]	Ruby J, Barbeau J. The buccale puzzle: the symbiotic nature of endogenous infections of the oral cavity. Canadian Journal of Infectious Diseases 2002; 13(1): 34–41. https://doi.org/10.1155/2002/492656
[14]	Berezow AB, Darveau RP. Microbial shift and periodontitis. Periodontol 2000. 2011; 55(1): 36–47. https://doi.org/10.1111/j.1600-0757.2010.00350.x
[15]	AlJehani YA. Risk factors of periodontal disease: review of the literature. Int J Dent 2014; 2014: 182513. https://doi.org/10.1155/2014/182513
[16]	Velsko IM., Fellows Yates JA, Aron F, et al. Microbial differences between dental plaque and historic dental calculus are related to the oral biofilm maturation stage. Microbiome 2019; 7: 102. https://doi.org/10.1186/s40168-019-0717-3
[17]	Marsh PD. Dental plaque as a microbial biofilm. Caries Res 2004; 38: 204–211. https://doi.org/10.1186/1472-6831-6-S1-S14
[18]	Kolenbrander PE, Andersen RN, Kazmerak KM, Palmer RJ. Coaggregation and adhesion in oral biofilms. In: Allison DG, Gilbert P, Lappin-Scott HM, Wilson M, editor. Community structure and co-operation in biofilms. Cambridge, Cambridge University Press, Society for General Microbiology Symposium 59 2000; 65–85.
[19]	Patil V, N M. S. Concrescence and Periodontitis: A Case Report. The Internet Journal of Dental Science 2009; 8: 2. https://doi.org/10.4103/0972-124X.115647
[20]	Valkenburg C, Weijden F, Slot D. Plaque control and reduction of gingivitis: The evidence for dentifrices. Periodontol 2000 2019; 79(1): 221-232. https://doi.org/10.1111/prd.12257
[21]	Rowe DJ, Weyant R. Powered toothbrushes may reduce plaque and gingivitis at least as effectively as manual toothbrushing. J Evid Based Dent Pract 2005; 5(3): 139-140. https://doi.org/10.1016/j.jebdp.2005.06.007
[22]	Davidovich E, Grenier J, and Zini A. Factors Associated with Dental Plaque, Gingivitis, and Caries in a Pediatric Population: A Records-Based Cross-Sectional Study. Int J Environ Res Public Health 2020; 17(22): 8595. https://doi.org/10.3390/ijerph17228595
[23]	Gillette WB, Van House RL. Ill effects of improper oral hygiene procedure. J Am Dent Assoc 1980; 101(3): 476-480. https://doi.org/10.14219/jada.archive.1980.0295
[24]	Jafer M, Patil S, and Hosmani J, et al. Chemical Plaque Control Strategies in the Prevention of Biofilm-associated Oral Diseases. J Contemp Dent Pract 2016; 17(4): 337-343. https://doi.org/10.5005/jp-journals-10024-1851
[25]	Thosar N. et., al. Changing Trends in Oral Hygiene and Plaque Control in Children. J Dent & Oral Care 2016; 3(1): 1-5. https://doi.org/10.15436/2379-1705.15.026
[26]	Sugano N. Biological plaque control: novel therapeutic approach to periodontal disease. J Oral Sci 2012; 54(1): 1-5. https://doi.org/10.2334/josnusd.54.1
[27]	Hammerman C, Bin-Nun A, Kaplan M. Safety of probiotics: comparison of two popular strains. BMJ 2006; 333(7576): 1006-1008. https://doi.org/10.1136/bmj.39010.630799.BE
[28]	Thakur A, Ganeshpurkar A, Jaiswal A. Charcoal in Dentistry. Natural Oral Care in Dental Therapy, 2020; 197–209. https://doi.org/10.1002/9781119618973.ch13
[29]	Fattai RK, Risovannaya ON, Comparative Evaluation of the Major Groups of manual toothbrush efficiency and their effect on oral hygiene status. Archive Euromedica.2019; 9: https://doi.org/10.35630/2199-885X/2019/9/1/155
[30]	Raggio DP, Braga MM, Rodrigues JA, Freitas PM, et al. Reliability and discriminatory power of methods for dental plaque quantification. J Appl Oral Sci. 2010; 18(2): 186-193. https://doi.org/10.1590/S1678-77572010000200014
[31]	Han SY, Kim BR, Ko HY, Kwon HK, Kim BI. Validity and reliability of autofluorescence-based quantification method of dental plaque. Photodiagnosis Photodyn Ther. 2015; 12(4): 587-591. https://doi.org/10.1016/j.pdpdt.2015.10.003
[32]	Maduakor S, Lauverjat Y, Cadot S, et al, Application of Community Periodontal Index Treatment Need (CPITN) In Enugu (Nigeria). Study of Secondary School Students Aged Between 12-18 Years 2000; Odontostomatol Trop 82(138), 110.
[33]	Aspalli S, Shetty VS, Devarathnamma MV, Nagappa G, Archana D, Parab P. Evaluation of the antiplaque and antigingivitis effect of herbal mouthwash in the treatment of plaque-induced gingivitis: A randomized, clinical trial. J Indian Soc Periodontol. 2014 Jan; 18(1): 48-52. https://doi.org/10.4103/0972-124X.128208
[34]	Wu P, Tu K, Lu L, Chang H, Lu, K. Quantitative analysis of Miller mobility index for the diagnosis of moderate to severe periodontitis - A cross-sectional study. Journal of Dental Sciences. 2018; 13(1), 43-47. https://doi.org/10.1016/j.jds.2017.11.001
[35]	Thamke MV, Beldar A, Thakkar P, Murkute S, Ranmare V, Hudwekar A. Comparison of Bacterial Contamination and Antibacterial Efficacy in Bristles of Charcoal Toothbrushes versus Non-charcoal Toothbrushes: A Microbiological Study. Contemp Clin Dent. 2018; 9(3): 463-467. https://doi.org/10.4103/ccd.ccd_309_18
[36]	Kaur S. Efficacy of two commercially available manual toothbrushes for removal of dental plaque. J Adv Med Dent Scie Res 2021; 9(1): 72-75. https://doi.org/10.21276/jamdsr
[37]	Prusty AK, Sharma S, Malhotra S. Comparative efficacy of different varieties of toothbrushes in plaque control: A 12-week clinical trial. Indian J Dent Res [serial online] 2021; 32: 372-9. https://doi.org/10.4103/ijdr.IJDR_179_20
[38]	Bhimani R. A. Kothiwale, S V. Comparison and assessment of the oral hygiene status and user satisfaction of a novel toothbrush and a regular commercial toothbrush: A questionnaire study. Indian Journal of Health Sciences and Biomedical Research (KLEU) 2017; 10(2): 160-166. https://doi.org/10.4103/kleuhsj.ijhs_397_16
[39]	Janakiram S, Muthuraj MSA, Chithresan K, Maddur P, Madhusoodanan, M. The Comparative Plaque Removal Efficacy of Charcoal Based and Non-Charcoal Based Manual Toothbrushes: A Clinical Study. Clinical Dentistry. 2022; 16(6): 12 -16. https://doi.org/10.33882/ClinicalDent.15.30609
[40]	Siyasinghe NM, Sooriyarachichi MR, Guidelines for calculating of sample size in 2x2 cross-over simulation study. J Nain sci foundation Sri Lanka 2011 39(1): 77-89. https://doi.org/10.4038/jnsfsr.v39i1.2929
[41]	Opeodu OI, Arowojolu MO, Gbadebo SO, et al. An audit of a pattern of patients’ presentation at the periodontics clinic of the University College Hospital, Ibadan. Ann Ibadan Postg Med. 2009; 7(1): 16-20. https://doi.org/10.4314/aipm.v7i1.64057
[42]	Schulz KF, Altman DG, ((Moher D; for the CONSORT Group)) "CONSORT 2010 Statement: updated guidelines for reporting parallel group randomized trials". Br Med J. 2010; 340: c332 https://doi.org/10.1186/1741-7015-8-18
[43]	Lim, C. Y., & In, J. (2021). Considerations for crossover design in clinical study. Korean journal of anesthesiology. 74(4), 293–299. https://doi.org/10.4097/kja.21165
[44]	Nazir M. A. Prevalence of periodontal disease, its association with systemic diseases and prevention. International journal of health sciences, 2017; 11(2), 72–80.
[45]	Adegbembo, A. O., & el-Nadeef, M. A. National survey of periodontal status and treatment need among Nigerians. International dental journal, 1995; 45(3), 197–203.
[46]	Popoola BO, Dosumu EB, Ifesanya JU. Periodontal status and treatment need among adolescents in Ibadan, Southwestern Nigeria. Brazilian Journal of Oral Sciences. 2015; 14: 117– 121. https://doi.org/10.1590/1677-3225v14n2a04
[47]	Kolawole KA, Oziegbe EO, Bamise CT. Oral hygiene measures and the periodontal status of school children. Int J Dent Hyg. 2011; 9: 143-8. https://doi.org/10.1111/j.1601-5037.2010.00466.x
[48]	Soroye MO, Braimoh OB. Omitola OG Prevalence and pattern of presentation of periodontal diseases at the periodontal clinic of a tertiary health institution in Port Harcourt, Nigeria. AJOL. 2014; 8(3).
[49]	Ohamaeme MC, Egwurugwu J, Ebuenyi MC, et al. Prevalence of Periodontal Diseases in Orlu Local Government Area of Imo State, Nigeria. JDMS. 2017; 16(6): 102-107. https://doi.org/10.9790/0853-160603102107
[50]	Omitola OG, Arigbede AO. Prevalence and pattern of pain presentation among participants attending a tertiary Dental Centre in a Southern region of Nigeria. J Dent Res Dent Clin Dent Prospect 2010; 4: 42-46. https://doi.org/10.5681/joddd.2010.012
[51]	Versteeg PA, Rosema NAM, Timmerman MF, et al. Evaluation of two soft manual toothbrushes with different filament designs about gingival abrasion and plaque removal efficacy. Int J Dent Hygiene. 2008; 6(3): 166-173. https://doi.org/10.1111/j.1601-5037.2008.00298.x
[52]	Bamigboye, O., & Akande, T. M. Oral hygiene status of students in selected secondary schools in Osogbo, Nigeria. Nig Med Pract, 2007; 51, 71-75. https://doi.org/10.4314/nmp.v51i4.28845
[53]	Santhosh K, Jyothi T, Prabu D, Suhas K. Socio-behavioral variables affecting oral hygiene and periodontal status of 12-year-old schoolchildren of Udaipur district. Odonto-stomatologie Tropicale = Tropical Dental Journal. 2013 Mar; 36(141): 27-33.
[54]	Hedge S, Kakade AA, Rajesh KS, et al. Evaluation of plaque removal efficacy of two manual toothbrushes with different textures: a comparative analysis. Journal of Oral Health Research. 2011; 2(3): 84-90. https://doi.org/10.4034/PBOCI.2019.191.05
[55]	Somnathe S, Gothane D, Chapade A et al. Comparison of plaque removal efficacy of toothbrush with bristle containing Neem and Charcoal for maintaining oral hygiene. A Randomized Clinical Trial. JCDR 2022; 16(10): 2031-2034). https://doi.org/10.7860/JCDR/2022/55416.17036
[56]	Ballini A, Di Cosola M, Saini R, Benincasa C, Aiello E, Marrell, B., et al. A Comparison of Manual Nylon Bristle Toothbrushes versus Thermoplastic Elastomer Toothbrushes in Terms of Cleaning Efficacy and the Biological Potential Role on Gingival Health. Appl. Sci. 2021; 11: 7180. https://doi.org/10.3390/app11167180
[57]	Sharma NC, Qaqish JG, Galustians HJ, et., al. A 3-month comparative investigation of the safety and efficacy of a new toothbrush: results from two independent clinical studies. American Journal of Dentistry. 2000; 13: 27A-32.

Cite This Article

Plain Text BibTeX RIS

APA Style

Obianuju, A. V., Adebola, E., Rebecca, E. (2025). Comparison of Periodontal Status of Adult Individuals Using Charcoal and Regular Nylon Toothbrushes in a Nigerian Health Facility. Clinical Medicine Research, 14(1), 1-11. https://doi.org/10.11648/j.cmr.20251401.11

Copy | Download

ACS Style

Obianuju, A. V.; Adebola, E.; Rebecca, E. Comparison of Periodontal Status of Adult Individuals Using Charcoal and Regular Nylon Toothbrushes in a Nigerian Health Facility. Clin. Med. Res. 2025, 14(1), 1-11. doi: 10.11648/j.cmr.20251401.11

Copy | Download

AMA Style

Obianuju AV, Adebola E, Rebecca E. Comparison of Periodontal Status of Adult Individuals Using Charcoal and Regular Nylon Toothbrushes in a Nigerian Health Facility. Clin Med Res. 2025;14(1):1-11. doi: 10.11648/j.cmr.20251401.11

Copy | Download

@article{10.11648/j.cmr.20251401.11,
  author = {Amuh Veronica Obianuju and Ehizele Adebola and Ezebor Rebecca},
  title = {Comparison of Periodontal Status of Adult Individuals Using Charcoal and Regular Nylon Toothbrushes in a Nigerian Health Facility
},
  journal = {Clinical Medicine Research},
  volume = {14},
  number = {1},
  pages = {1-11},
  doi = {10.11648/j.cmr.20251401.11},
  url = {https://doi.org/10.11648/j.cmr.20251401.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20251401.11},
  abstract = {The high prevalence of periodontal disease in adolescents, adults, and older individuals makes it a public health concern. Although studies have been reported on the efficacy of charcoal-infused versus Nylon toothbrushes on periodontal health, there appears to be a lack of documented reports. This study compared individuals' periodontal health using a charcoal-infused and a regular nylon bristle toothbrush. This randomized clinical crossover study recruited all consecutive participants who presented to the Department of Periodontics at a tertiary facility for scaling, between May 2022 to April 2023. Each participant made use of each toothbrush; Charcoal-infused and Nylon toothbrush. Participants were instructed to brush with either toothbrush and the same fluoride toothpaste, morning and evening after meals, for three minutes and with the modified Bass technique. They were recalled after three weeks for assessment and the PI, GI, and CPITN were recorded at baseline and after three weeks of use of toothbrushes. After six months of washout (using whatever individual was used to), the toothbrush was exchanged, and the same procedure and assessments were done. Data collected were Biodata (age, sex, marital status, occupation, education, and ethnic group) and records of PI, GI, and CPITN values. A level of significance was set at p<0.05. All analysis was done with SPSS software version 26, (IBM, Armonk, New York, US). A total of twenty - two adults with a mean age of 32.82±12.19 years were recruited in this study. There was an improvement in periodontal status as all the participants had healthy gingivae at the end of the study. There was a significant reduction of the mean CPITN values for charcoal (p=0.0001) and Nylon (p= 0.001) over three weeks. However, there was no statistically significant difference in PI, GI, and CPITN (p =0.757, p =0.806, p =0.391, and p =0.1) respectively. The charcoal-infused toothbrush was not better than the Nylon bristle toothbrush in maintaining the periodontal status of participants in this study over three weeks. However, the periodontal status of participants was positively impacted.
},
 year = {2025}
}

Copy | Download

TY - JOUR
T1 - Comparison of Periodontal Status of Adult Individuals Using Charcoal and Regular Nylon Toothbrushes in a Nigerian Health Facility

AU - Amuh Veronica Obianuju
AU - Ehizele Adebola
AU - Ezebor Rebecca
Y1 - 2025/02/24
PY - 2025
N1 - https://doi.org/10.11648/j.cmr.20251401.11
DO - 10.11648/j.cmr.20251401.11
T2 - Clinical Medicine Research
JF - Clinical Medicine Research
JO - Clinical Medicine Research
SP - 1
EP - 11
PB - Science Publishing Group
SN - 2326-9057
UR - https://doi.org/10.11648/j.cmr.20251401.11
AB - The high prevalence of periodontal disease in adolescents, adults, and older individuals makes it a public health concern. Although studies have been reported on the efficacy of charcoal-infused versus Nylon toothbrushes on periodontal health, there appears to be a lack of documented reports. This study compared individuals' periodontal health using a charcoal-infused and a regular nylon bristle toothbrush. This randomized clinical crossover study recruited all consecutive participants who presented to the Department of Periodontics at a tertiary facility for scaling, between May 2022 to April 2023. Each participant made use of each toothbrush; Charcoal-infused and Nylon toothbrush. Participants were instructed to brush with either toothbrush and the same fluoride toothpaste, morning and evening after meals, for three minutes and with the modified Bass technique. They were recalled after three weeks for assessment and the PI, GI, and CPITN were recorded at baseline and after three weeks of use of toothbrushes. After six months of washout (using whatever individual was used to), the toothbrush was exchanged, and the same procedure and assessments were done. Data collected were Biodata (age, sex, marital status, occupation, education, and ethnic group) and records of PI, GI, and CPITN values. A level of significance was set at p<0.05. All analysis was done with SPSS software version 26, (IBM, Armonk, New York, US). A total of twenty - two adults with a mean age of 32.82±12.19 years were recruited in this study. There was an improvement in periodontal status as all the participants had healthy gingivae at the end of the study. There was a significant reduction of the mean CPITN values for charcoal (p=0.0001) and Nylon (p= 0.001) over three weeks. However, there was no statistically significant difference in PI, GI, and CPITN (p =0.757, p =0.806, p =0.391, and p =0.1) respectively. The charcoal-infused toothbrush was not better than the Nylon bristle toothbrush in maintaining the periodontal status of participants in this study over three weeks. However, the periodontal status of participants was positively impacted.

VL - 14
IS - 1
ER -

Copy | Download

Author Information

Amuh Veronica Obianuju

Department of Family Dentistry, University of Benin Teaching Hospital, Benin City, Nigeria

Contact Email

http://orcid.org/0009-0000-8403-1485
Ehizele Adebola

Department of Family Dentistry, University of Benin Teaching Hospital, Benin City, Nigeria

http://orcid.org/0000-0002-9596-2020
Ezebor Rebecca

Department of Family Dentistry, University of Benin Teaching Hospital, Benin City, Nigeria

Download PDF

Plain Text BibTeX RIS

APA Style

Obianuju, A. V., Adebola, E., Rebecca, E. (2025). Comparison of Periodontal Status of Adult Individuals Using Charcoal and Regular Nylon Toothbrushes in a Nigerian Health Facility. Clinical Medicine Research, 14(1), 1-11. https://doi.org/10.11648/j.cmr.20251401.11

Copy | Download

ACS Style

Obianuju, A. V.; Adebola, E.; Rebecca, E. Comparison of Periodontal Status of Adult Individuals Using Charcoal and Regular Nylon Toothbrushes in a Nigerian Health Facility. Clin. Med. Res. 2025, 14(1), 1-11. doi: 10.11648/j.cmr.20251401.11

Copy | Download

AMA Style

Obianuju AV, Adebola E, Rebecca E. Comparison of Periodontal Status of Adult Individuals Using Charcoal and Regular Nylon Toothbrushes in a Nigerian Health Facility. Clin Med Res. 2025;14(1):1-11. doi: 10.11648/j.cmr.20251401.11

Copy | Download

@article{10.11648/j.cmr.20251401.11,
  author = {Amuh Veronica Obianuju and Ehizele Adebola and Ezebor Rebecca},
  title = {Comparison of Periodontal Status of Adult Individuals Using Charcoal and Regular Nylon Toothbrushes in a Nigerian Health Facility
},
  journal = {Clinical Medicine Research},
  volume = {14},
  number = {1},
  pages = {1-11},
  doi = {10.11648/j.cmr.20251401.11},
  url = {https://doi.org/10.11648/j.cmr.20251401.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20251401.11},
  abstract = {The high prevalence of periodontal disease in adolescents, adults, and older individuals makes it a public health concern. Although studies have been reported on the efficacy of charcoal-infused versus Nylon toothbrushes on periodontal health, there appears to be a lack of documented reports. This study compared individuals' periodontal health using a charcoal-infused and a regular nylon bristle toothbrush. This randomized clinical crossover study recruited all consecutive participants who presented to the Department of Periodontics at a tertiary facility for scaling, between May 2022 to April 2023. Each participant made use of each toothbrush; Charcoal-infused and Nylon toothbrush. Participants were instructed to brush with either toothbrush and the same fluoride toothpaste, morning and evening after meals, for three minutes and with the modified Bass technique. They were recalled after three weeks for assessment and the PI, GI, and CPITN were recorded at baseline and after three weeks of use of toothbrushes. After six months of washout (using whatever individual was used to), the toothbrush was exchanged, and the same procedure and assessments were done. Data collected were Biodata (age, sex, marital status, occupation, education, and ethnic group) and records of PI, GI, and CPITN values. A level of significance was set at p<0.05. All analysis was done with SPSS software version 26, (IBM, Armonk, New York, US). A total of twenty - two adults with a mean age of 32.82±12.19 years were recruited in this study. There was an improvement in periodontal status as all the participants had healthy gingivae at the end of the study. There was a significant reduction of the mean CPITN values for charcoal (p=0.0001) and Nylon (p= 0.001) over three weeks. However, there was no statistically significant difference in PI, GI, and CPITN (p =0.757, p =0.806, p =0.391, and p =0.1) respectively. The charcoal-infused toothbrush was not better than the Nylon bristle toothbrush in maintaining the periodontal status of participants in this study over three weeks. However, the periodontal status of participants was positively impacted.
},
 year = {2025}
}

Copy | Download

TY - JOUR
T1 - Comparison of Periodontal Status of Adult Individuals Using Charcoal and Regular Nylon Toothbrushes in a Nigerian Health Facility

VL - 14
IS - 1
ER -

Copy | Download