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J Indian Soc Periodontol. 2019 Sep-Oct;23(5):469-474. doi: 10.4103/jisp.jisp_529_18.

A 12-week, multicenter, normal-use evaluation of a manual toothbrush with angled bristle design.

Author information

Department of Periodontology, Visiting Faculty, M.G.M. Dental College, Panvel, Maharashtra, India.
Private Practitioner, Mumbai, Maharashtra, India.
Regional Manager, Procter and Gamble, Professional Oral Care, London/Weybridge, UK.



Comparative clinical studies play a major role in evaluating the relative efficacy of commercially available manual toothbrushes to improve periodontal health. A manual toothbrush with angled, CrissCross® bristles has been shown to offer significant benefits relative to other toothbrushes. This study assessed whether the benefits could also be observed in real-world, normal use conditions in a large population.

Materials and Methods:

Generally, healthy adult participants were recruited from 24 dental institutions across India and given the manual toothbrush with angled bristles to use. Their periodontal health was assessed subjectively by dentists, using response categories, at the start of the study (baseline) and after 12 weeks of normal use. Participants themselves were also questioned. Data analyses were descriptive.


A total of 2157 participants took part in this multicenter study. At 12 weeks, oral hygiene status and gingival health were categorized as good to excellent in at least 85% of participants compared with 61%-62% at baseline, and no staining was found in 40% of participants compared with 30% at baseline. Oral health improvements were seen in 75% of participants. Most participants reported their brushing experience as giving good-to-excellent satisfaction (85%), improved brushing (82%), and a cleaner mouth (81%) and said they would recommend the brush (90%).


In this uncontrolled real-world study, improvements were observed in oral health and hygiene following the use of the manual toothbrush with CrissCross bristles over 12 weeks. The results lend support to earlier findings of comparative clinical studies that demonstrated the beneficial effects of this toothbrush for periodontal health.


Angled bristles; manual toothbrush; normal-use study

Conflict of interest statement

Dr. Saurabh Saraf is an empolyee of Procter & Gambel UK. Dr. Ajay Kakar and Dr. Smruti Nair were commissioned by Procter & Gamble to advise, plan and oversee the program.

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