Plaque Removal Efficacy of Chewing Apples and Tooth-Brushing: A Comparative Cross Over Clinical Study

Background: The best and the most reliable methods to manage the dental plaque are still mechanical procedures. It has been traditionally recommended that a firm fruit such as an apple be eaten to minimize caries and control plaque at the end of a meal. However, several studies have reported contradictory findings about the microbial plaque function of the apples. Some studies, for instance, have found that apples contain sugar and, therefore, can cause plaque growth; some other researches, on the other hand, have shown that they have the potential to decrease plaque due to their mechanical plaque removal function. This study, therefore, aimed to compare the effects of apple-chewing method and that of tooth-brushing one on plaque removal. Methods: The study group included 48 healthy dental students with good oral health status, who were randomly selected to participate in this comparative, crossover clinical study. First, they were asked to brush their teeth or eat an apple. After 2 weeks, the experiment was repeated with the order reversed. Plaque indexes (PIs) were determined as before brushing/apple eating (baseline, B), immediately afterward (A), and 24 hours afterward (24). Results: Over time, there was a significant shift in the plaque index pattern between the groups (P value<0.001) but this discrepancy, in general, was not significant between the group using apple and the one using toothbrush (P value =0.495), as well as between the group using yellow apples, and the ones using red apples or the toothbrushes (P value =0.768). Conclusions: Comparing the two plaque control methods, it was found they were extremely similar; however, chewing yellow apples was discovered to be more effective method in reducing dental plaque than chewing red apples or using toothbrushes.