Toothbrushing: to the best of one’s abilities is possibly not good enough

Table 1 The Quality index of toothbrushing regarding brushing time in sextants (QIT-S^a)

QIT-S-0	0 sextants brushed by more than 1 s
QIT-S-1	1 sextants brushed by more than 1 s
QIT-S-2	2 sextants brushed by more than 1 s
QIT-S-3	3 sextants brushed by more than 1 s
QIT-S-4	4 sextants brushed by more than 1 s
QIT-S-5	5 sextants brushed by more than 1 s
QIT-S-6	all sextants brushed by more than 1 s
QIT-S-7	all sextants brushed by more than 3.5 s
QIT-S-8	all sextants brushed by more than 5 s
QIT-S-9	all sextants brushed by more than 7.5

^aThe QIT-S index represents a rank-scaled measure allowing for the differential analysis of brushing time distribution at palatinal and vestibular sites, respectively. Brushing time of less than 1 s within a sextant is considered neglect of this sextant. QIT-S-0 ─ QIT-S-6 describe the expansion of this neglect. The highest score (QIT-S-9) is deduced from a recommended total brushing time of 2 min (e.g. 19 [19]; 18 [18]; 20 [20]) and an estimation of 30 s brushing time for occlusal surfaces as occlusal brushing is easier and can be done with greater movements than palatinal or vestibular brushing. Thereby, 45 s remain for the palatinal and vestibular surfaces, respectively. An even distribution of this time across sextants results in 7.5 s per sextant. As 3.5 represents roughly half of 7.5 this is taken as further step (QIT-S-7) and as 5 s per sextant might already be considered fair this was taken as another step (QIT-S-8)