If oral hygience is neglected or discontinued,plaque growth reaches its maximum extent within 3-4 days,and plaque accumulation is detected on almost all tooth surfaces.Therefore,in population without access to customary oral hygience devices such as toothbrushes,up to approximately 95% of assessed surfaces exhibit visible plaque.In contrast,patients living in industrialized countries and practicing regular oral hygience have on average only 40% and 60% of tooth surfaces covered with plaque.After manual toothbrushing,most plaque remnants are found in the mandibular molars.The instructed use of newly designed power-driven toothbrushes has been shown to enhance cleaning effectiveness,especially in these regions.The higher efficacy of these devices may in part laso be ascribed to advances in brush design,such as more compact brush heads with concentrically oriented bristles.Additionally,though designed primarily for the removal of surpragingival plaque,the use of both powered and manual toothbrushes may allo penetration of the subgingival area to a maximum depth of about 0.9 to 1.5mm.

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