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Investigations were made of the forces during brushing of the teeth, the patterns of brushing movements, and muscle activities, with and without blockage of sensory perception in the oral cavity, while each subject brushed by the rolling method, scrubbing method, and by his own individual habitual brushing method. We learned from electromyograms that the scrubbing method primarily used the muscles of the palm of the hand and the forearm, while the rolling method cleaned principally by action of the muscles of the upper arm and shoulder. With the rolling method, the rhythmic pattern of the brushing movement and muscle activity were lost when sensory perception in the oral cavity was blocked and, in those subjects who had a low periodontal membrane tactile threshold, the brushing force was greater than when sensory perception was not blocked. However, no effect was observed with blockage of the sensory perception in the oral cavity when the scrubbing method was used. Since brushing movements with the scrubbing method resemble the movements of writing, we also carried out investigations on the relationship between the forces during writing and brushing. As a result we found that with the scrubbing method, the brushing forces were strong for the subjects who had strong writing forces, while they were weak for those with weak writing forces. It was clear from the above results that the force of brushing with the rolling method was affected more by factors relating to oral sensory perception than muscle activity, while with the scrubbing method it was affected more by factors relating to muscle activity of the palm of the hand and forearm than by oral sensory perception. There was a clear difference in the brushing forces, pattern of brushing movements, and muscle activity between experienced and inexperienced subjects with both the scrubbing and rolling methods. Thus we learned that the effect of brushing instructions could be evaluated not only by the efficiency of plaque removal, brushing force or skill of brushing movements, but also by muscle activity. The phenomena observed with the scrubbing and rolling methods were not seen with the subjects' individual habitual brushing method.

Muscle activities in the hand and arm during tooth brushing and the regulation of brushing movements by oral sensory perception.