Sir, in recent years interdental space cleaning brushes in various diameters have become an important part of patients' home plaque control because 'in order to achieve the highest standards of interdental cleaning, interdental brushes are the most effective'.1Many different manufacturers now provide these important aids to oral hygiene. The brush heads themselves may be parallel sided or tapered. Handles vary from those in line with the brush head to various angled devices, creating a wide range of options for prescribers and their patients.

Unfortunately, there is little commonality between the different diameters on the market and the colour codes used by the manufacturers to identify the handles of their own size range. This can cause problems for patients, particularly if they attempt to buy brushes, for example online, and choose the cheapest available in that colour, forgetting that they need to follow the definitive sizes for the original maker's brushes prescribed by their dentist or hygienist. It follows that dental professionals, when they prescribe brushes, also need to advise patients to use their chosen manufacturer's brushes.

An alternative to suggesting patients just buy further brushes is for practices to stock brushes and advise patients that they can buy replacements from them. This has the following advantages:

  • It ensures that the correct make, as prescribed, is used

  • It allows the prescriber to monitor each patient's usage, or lack thereof

  • It provides a further source of income for the practice.

Table 1 shows some of the choices available from internet research for parallel-sided brushes and is by no means exhaustive, particularly as some manufacturers do not disclose the diameters of their brushes online. It follows that patients seeking the cheapest possible brush could easily be confused by the plethora of options available. It is also clear from this study that patients requiring large diameter brushes where there is significant bone loss have limited choices; either Tandex or TEPE. There is no standard relationship between brush diameter and handle colour although it would appear that more follow the TEPE pattern. This could form the basis for standardisation. Manufacturers should also give brush diameters on their various packages.

Table 1 Parallel-sided interdental brush comparisons across various manufacturers
Full size table

A similar situation of non-standardisation existed with endodontic files in the past, before the current international standard colours were agreed. It seems to me that the time is now appropriate for a similar ISO standardisation programme for interspace brushes and that this should be brought to the attention of the relevant International Standards body.