Assessment of User Satisfaction of Bamboo Toothbrushes Among Students of Dental Institute of North Gujarat A Questionnaire Study

Volume 7, Issue 6, June – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Assessment of user Satisfaction of Bamboo

Toothbrushes among Students of Dental Institute
of North Gujarat: A Questionnaire Study
DR. KETY PILCHER, DR. DRASHTI VAISHNAV, DR. PINKAL ASODIYA, DR. BHOOMI AMODRA,
DR. BHOOMI AGRAWAL, DR. DEEPA BHAGVAT, DR. DHARA BHAGADIYA, DR. DHRUMAN ACHARYA
Abstract: I. INTRODUCTION
Introduction: There are many novel toothbrushes which
are available in the market today. The most sustainable Dental plaque has been defined as a highly variable
option among all is the Bamboo toothbrush. Till date structural entity resulting from sequential colonization of
there have not been many studies conducted, in our area microbes on tooth surfaces, restorations or parts of
which demonstrated the efficacy of bamboo tooth prosthesis. It is pale yellowish, sticky substance adhering to
brushes in maintaining oral hygiene. the tooth surface either above the gingival margin
(supragingival plaque) or below the gingival margin
Objectives: To assess the user satisfaction of bamboo (subgingival plaque).1 These deposits of dental plaque are
toothbrushes among students of a dental college in North found in the proximal areas, along the gingival margins and
Gujarat. on the defects of the teeth or on restorations. These areas are
maintained free of plaque by the natural cleansing
Materials and Methods: A triple blind randomized mechanism of the oral cavity.2 Many times, it is found in
controlled study was conducted among the 40 dental some individuals, that plaque deposits are adhered to the
students for a period of 3 months. They were divided tooth surfaces, which are not cleaned by the natural
into 2 groups, were given oral hygiene instructions and cleansing mechanism of the saliva.2 Deposits of dental
brushing technique demonstration at the beginning of plaque, if left untreated, on tooth surface, may lead to
the study. At the end of the 2 months, the participants stagnation of the surrounding tissues. This may lead to the
were made to fill a Google form questionnaire to assess destruction of the protective tissues leading to gingivitis and
the user satisfaction of using the toothbrush given to periodontitis.1 Lekholm et al have also shown a direct
them. correlation between the levels of dental plaque and an
increased probing depth.3
Results: 40 students had participated in the present
study (20 males and 20 females). They were randomly Plaque control is of utmost importance in maintaining
allotted to 2 groups such that each group had 10 males the healthy oral hygiene of individuals.4 Effective plaque
and 10 females. The mean age of the study participants control techniques are of 2 types: Mechanical and Chemical.
was 21.45 ± 2.11 years. From the above results it can be Proper tooth brushing is the easiest and cheapest method of
seen that among the males majority from both the maintaining oral hygiene. 4
groups and among the females 60% from both the
groups agreed that the toothbrushes allotted to them The toothbrush invention dates back to the early 1600s.
were sustainable. It was designed to promote the cleanliness of the teeth and
the oral cavity. In India, before the invention of the
Conclusion: It was concluded that the bamboo toothbrush, people used “chewing sticks” for maintenance
toothbrushes were a sustainable option as compared to of oral hygiene. The first modern toothbrush was made from
the plastic toothbrushes. an ox thigh bone and the bristles were made from cow’s tail.
Eventually the toothbrushes underwent evolutionary
Keywords:- Bamboo toothbrush, environment, satisfaction, changes and nylon bristles, plastic handles came into
sustainability. existence. Ever since then, many toothbrushes with different
handles and bristles and neck designs have come into
existence.5 Electric and sonic toothbrushes are also
inventions which are said to help individuals with impaired
dexterity to maintain oral hygiene.5
A common feature among all the toothbrushes is that

the body of the toothbrush is usually made of plastic with
nylon bristles. Nylon bristles are found to be reusable or if
being degraded, they donot take as long as plastic to
degrade. Plastic on the other hand, is non biodegradable and
is reusuable only in some forms and parts. The remainder of
the plastic of the toothbrush is left to haunt the landfills for
many years.6
IJISRT22JUN460 www.ijisrt.com 187

ISSN No:-2456-2165
Environmental sustainability is the biggest problem wished to. Study participants were aged between 18 – 25
faced by healthcare professionals, globally. Global years.
healthcare is a significant contributor to carbon dioxide
emissions. Improving carbon footprint is a common C. Inclusion criteria:
environmental goal for healthcare professionals.7 The  Individuals willing to give written informed consent.
National Health Service in the United Kingdom considers it  All individuals from 1st year BDS to Interns were
a success if healthcare professionals are encouraged to included in the study.
consider sustainability principles when deciding treatments  Individuals having good general health.
protocols for their patients.8 D. Exclusion Criteria:
 Individuals not willing to give informed consent.
Taking into account the environmental sustainability,  Individuals who had undergone oral prophylaxis in the
the bamboo toothbrush was used in the current study to last 3 months.
assess its user satisfaction among students of a private dental  Individuals undergoing orthodontic treatment or
institute in North Gujarat. wearing fixed orthodontic retainers.
II. METHODOLOGY The individuals were randomly given numbers from 1-
This triple blind, randomized, parallel study was 40 and were divided into 2 groups based on odd- even
conducted among dental students in a private dental college numbers. All individuals belonging to the odd number group
from August 2021 – October 2021 for a period of 3 months. were given the Bamboo toothbrush (TB1) and those
Two types of toothrushes were used – plastic toothbrush and belonging to the even number group were given the Plastic
bamboo toothbrush. Ethical clearance was obtained from the toothbrush (TB2). They were then given the Modified Bass
Institutional Ethical Committee (IEC). Prior to the start of technique demonstration and were asked to brush with the
the study, written consent was taken from all the study given toothbrush twice daily for 3 months.
participants. E. Questionnaire:
A. Sample Size: At the end of 3 months, all individuals were asked to fill
Each group had 20 participants. Sample size calculation a Google form questionnaire. The questionnaire consisted of
2 parts – the first part consisted of demographic details and
was done based on literature and using the G Power
software. This sample size provided minimum 0.80 power the second part consisted of 21 questions related to the user
and 5% significance and minimum 0.77 effect. satisfaction of using the bamboo toothbrushes and the
plastic toothbrushes.
B. Selection of study participants:
F. Statistical Analysis:
Volunteers - students from the dental institute of North
Gujarat were invited to participate in the study. They were All the data was recorded into MS excel 2013.
informed about the study protocols and were also informed Percentages were calculated for each question.
about being free to leave the experiment at any time, if they
III. RESULTS
40 students had participated in the present study (20 males and 20 females). They were randomly allotted to 2 groups such
that each group had 10 males and 10 females. The mean age of the study participants was 21.45 ± 2.11 years.
TB1 TB2
Question
Yes No Yes No
Do you have the practice of using any inter dental aids? 00 10 (100%) 2 (20%) 8 (80%)
Did you experience any gingival (gum) bleeding while brushing prior to start of
00 10 (100%) 1 (10%) 9 (90%)
study?
Were you comfortable using the toothbrush allotted to you? 10 (100%) 00 7 (70%) 3 (30%)
Was the lodged food removed after brushing with the tooth brush allotted to
10 (100%) 00 8 (80%) 2 (20%)
you?
Were you able to incorporate the Modified Bass technique demonstration given to
10 (100%) 00 10 (100%) 00
you?
Were you comfortable using the toothbrush allotted to you? 10 (100%) 00 7 (70%) 3 (30%)
Were you able to clean the backmost teeth using the tooth brush allotted to you? 7 (70%) 3 (30%) 8 (80%) 2 (20%)
Was the tooth brush allotted to you sustainable? 7 (70%) 3 (30%) 6 (60%) 4 (40%)
According to you, are bamboo tooth brushes economical to use? 7 (70%) 3 (30%) 10 (100%) 0
Are bamboo tooth brushes currently available locally in your area? 5 (50%) 5 (50%) 7 (70%) 3 (30%)
Did you feel the need to use another dental aid for better cleaning experience
4 (40%) 6 (60%) 5 (50%) 5 (50%)
along with the tooth brush?
Did you find any difference in the bristles of the tooth brush allotted to you? 9 (90%) 1 (10%) 9 (90%) 1 (10%)
Table 1: Shows the responses of male study participants to the questionnaire

ISSN No:-2456-2165
TB1 TB2
Question
Yes No Yes No
Do you have the practice of using any inter dental aids? 2 (20%) 8 (80%) 1 (10%) 9 (90%)
Did you experience any gingival (gum) bleeding while brushing prior to
0 10 (100%) 0 10 (100%)
start of study?
Were you comfortable using the toothbrush allotted to you? 9 (90%) 1 (10%) 8 (80%) 2 (20%)
Was the lodged food removed after brushing with the tooth brush
9 (90%) 1 (10%) 9 (90%) 1 (10%)
allotted to you?
Were you able to incorporate the Modified Bass technique 10
9 (90%) 1 (10%) 0
demonstration given to you? (100%)
Were you comfortable using the toothbrush allotted to you? 9 (90%) 1 (10%) 8 (80%) 2 (20%)
Were you able to clean the backmost teeth using the tooth brush allotted
8 (80%) 2 (20%) 8 (80%) 2 (20%)
to you?
Was the tooth brush allotted to you sustainable? 6 (60%) 4 (40%) 6 (60%) 4(40%)
According to you, are bamboo tooth brushes economical to use? 9 (90%) 1 (10%) 4 (40%) 6 (60%)
Are bamboo tooth brushes currently available locally in your area? 3 (30%) 7 (70%) 4 (40%) 6 (60%)
Did you feel the need to use another dental aid for better cleaning
3 (30%) 7 (70%) 4 (40%) 6 (60%)
experience along with the tooth brush?
Did you find any difference in the bristles of the tooth brush allotted to
5 (50%) 5 (50%) 6 (60%) 4 (40%)
you?
Table 2: Shows the responses of female study participants in the questionnaire.
From the above results it can be seen that among the The current study was conducted with an aim to assess
males majority from both the groups and among the females the user satisfaction while using a bamboo toothbrush. In the
60% from both the groups agreed that the toothbrushes past, studies have been conducted with many other types of
allotted to them were sustainable. 100% of male participants toothbrushes like the electric toothbrush, the sonic
were comfortable using the bamboo toothbrush allotted to toothbrush, etc. This was the first study, conducted in our
them, whereas 90% female participants were comfortable area which used a bamboo toothbrush.
using the bamboo toothbrushes. None of the participants
from any genders and any groups had any bleeding gums In a study conducted by Bhimani et al, they reported
while brushing. similar results to our study regarding bleeding gums while
brushing. They stated that 85.96% study participants did not
IV. DISCUSSION experience any bleeding while brushing their teeth with the
toothbrush given to them. Both the toothbrushes used in our
Health interventions often include many unquantifiable study had soft bristles with end rounded filaments.5
variables which usually add layers of complexity to the Breintenmoser stated that manual toothbrushes with cut
environment. Many healthcare items although, life saving, filaments resulted in greater gingival lesions or gingival
(eg. Tablet packaging, vial bottles, syringes, etc) come in bleeding than end rounded filaments. 10
non environmental friendly packaging. These items in the
long run, have a damaging effect on the environment as they Male study participants who were allotted the bamboo
donot decompose easily.9 Toothbrush is one such example. toothbrush stated that they were able to remove the lodged
food from the tooth surfaces, whereas, among those males in
The toothbrush is the most effective and economical the plastic toothbrush group, 20% stated that they were not
way of mechanical plaque control. The major drawback of able to do so. Similarly, among females in the plastic
the toothbrush is that they have always been made of plastic, toothbrush group, 10% stated that they were unable to
which is harmful for the environment. In a study conducted remove the lodged food during brushing. In a similar study
by Duane B et al, it was stated that the production of the conducted by Bhimani et al, they found that 84.62% males
manual plastic toothbrushes produced around 2.5 million kg experienced residual food debris with the toothbrush allotted
CO2E, every year.9 to them. The authors have stated that a possible reason for
this could be the regular use of the medium/ hard toothbrush
A simple yet effective mechanical plaque control by males on a daily basis which made them believe that the
method could be initiated by the use of the bamboo soft bristled toothbrush was not effective due to its soft
toothbrushes. Bamboo is largely cultivated in China. For the texture. 6
making of the toothbrushes, the handle is completely carved
out of bamboo, whereas the brush bristles are made of nylon 20% females from both the groups reported that they
material.9 During the degradation process, only the nylon were unable to clean the backmost teeth with the toothbrush
bristles would take a longer time to decompose as compared allotted to them. Similarly, 30% males belonging to the
to the handle of the brush. It is important to note here that bamboo toothbrush group and 20% belonging to the plastic
the bristles would still take fewer years to decompose as toothbrush group couldn’t access their backmost teeth with
compared to the handle of the plastic toothrushes. 9 the toothbrush allotted to them. Kanchanakamol and
Srisilapanam have stated in their study that angulated
handles and neck design of toothbrush resulted in better

ISSN No:-2456-2165
plaque removal from the posterior teeth of individuals. 11 commercial toothbrush : a questionnaire study. Indian J
Khare et al in their study have stated that females have Health Sci Biomed Res. 2017;10:160-166.
lesser mouth opening than males which makes it difficult for [6.] Neelima M, Chandrasekhar BR, Goel S, Sushma R,
them to access the posterior most teeth in the mouth. This Srilatha Y. “Is powered toothbrush better than manual
statement is in contrast to the results obtained in our study. toothbrush in removing dental plaque?” – a Cross over
In our study, a higher number of male participants couldn’t randomized double blind study among differently
access the posterior most teeth as compared to females. 12 abled, India. J Indian Soc Periodontol. 2017;21:138-
143.
Lazarescu et al in their study have stated that patient [7.] Evans WG. Bamboozled…..or bamboo? SADJ. 2018;
compliance is of paramount importance and plays a vital 73 (10): 594-595.
role in mechanical plaque control methods. Encouragement [8.] Lyne A, Ashley P, Saget S, Costa M, Underwood B,
of patients on a repetitive basis with tailor made Duane B. Combining evidence based healthcare with
instructions, and demonstrating brushing technique to them environmental sustainability: using the toothbrush as a
help retain information better regarding the brushing model. Brit Dent J. 2020; 229(5): 303-309.
technique. Almost all the participants in the current study [9.] Duane B, Ashley P, Saget S, Richards D, Clewer E,
found the brushing technique demonstration to be useful to Lyne A. Incorporating sustainability into oral health
them and were able to incorporate it in their daily interventions. Bri Dent J. 2020; 229(5) : 310-314.
schedule.11,16 [10.] Breitenmoser J, Mormann W, Muhlemann HR.
Damaging effects of toothbrush bristles end forms on
The authors of this particular study believe that the gingiva. J Periodontol. 1979;50: 212-216.
results of this study can be put forward to the public to get [11.] Kanchanakamol U, Srisilapanan P. The effectiveness
an opinion of their perception regarding the manual use of of the newly designed “Concept 45 degrees”
the bamboo toothbrushes. Dentists should also actively take toothbrush for removal of dental plaque in primary
part in the policy making of such decisions which focuses school children. Int Dent J. 1992;42:78-82.
on environmental health as well as satisfaction of their [12.] Khare N, Patil SB, Kale SM, Sumeet J, Sonali I,
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The main limitations associated with the bamboo population. J Maxillofac Oral Surg. 2012; 11: 309-313.
toothbrush used in our study were that it did not have a
flexible neck design and it was expensive as compared to a
plastic, conventional toothbrush.
V. CONCLUSION
The current study throws some light on the user

satisfaction of using the bamboo toothbrushes. The authors
recommend that further studies should be done on
populations with intermediate or advanced dental diseases to
check for efficacy and on populations with limited mobility
to check for manual dexterity of such patients while using
this toothbrush.
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Volume 7, Issue 6, June – 2022 International Journal of Innovative Science and Research Technology

Assessment of user Satisfaction of Bamboo

A common feature among all the toothbrushes is that

IJISRT22JUN460 www.ijisrt.com 187

IJISRT22JUN460 www.ijisrt.com 188

IJISRT22JUN460 www.ijisrt.com 189

The current study throws some light on the user

[1.] Pampolin de Carvalho M, Florio F, Pereira S, Martin

IJISRT22JUN460 www.ijisrt.com 190

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