The goal of this clinical trial is to evaluate the effectiveness of an eco-friendly toothbrush compared to a conventional nylon-based toothbrush on cariogram parameters in children and adults. It will also assess the impact of toothbrush type on caries risk factors. The main questions it aims to answer are:

Does the use of an eco-friendly toothbrush improve cariogram parameters compared to a nylon-based toothbrush? Does toothbrush type influence overall caries risk in children and adults?

Participants will:

1. Be randomly assigned to use either an eco-friendly toothbrush or a nylon-based toothbrush
2. Use the assigned toothbrush as part of their daily oral hygiene routine for the study period
3. Attend scheduled follow-up visits for clinical examination and cariogram assessment

This study is a randomized controlled clinical trial designed to compare the effects of an eco-friendly toothbrush and a conventional nylon-based toothbrush on cariogram parameters in children and adults. Eligible participants will be classified by age group and randomly allocated into two intervention groups. At baseline, all participants will undergo clinical examination and caries risk assessment using the Cariogram model. Standardized oral hygiene instructions will be provided to all participants. Participants in each group will use the assigned toothbrush exclusively throughout the study period.

Follow-up assessments will be conducted at predetermined intervals to evaluate changes in cariogram parameters. Compliance with toothbrush use will be monitored during follow-up visits.

The primary outcome is the change in cariogram parameters from baseline to the end of the study period. Secondary outcomes include differences in overall caries risk profile between the two toothbrush groups and between age categories. Data will be analyzed to compare the effects of toothbrush type on cariogram outcomes while accounting for age-related differences

Inclusion Criteria:

• Children's age group: Participants must be within the age range of 8 to 11 years.

This age group is specifically chosen due to the prevalence of mixed dentition, which presents unique challenges and considerations for oral hygiene practices and assessment, and is considered as being a high caries risk profile according to the cariogram parameters. (Tavargeri & Banerjee, 2021)(Lodha, Saraf, & Jawdekar, 2023) Adults' age Group: Participants must be within the age range of 18 to 35 years consider as being a high caries risk profile according to the cariogram parameters.

(AlDhawi et al., 2020; Fageeh et al., 2024) and (Fouad et al., 2022)

Exclusion Criteria:

• For the children's age group:

  • Lack of parental/guardian consent for participation.
  • Currently undergoing orthodontic treatment (fixed or removable appliances).
  • Children with special healthcare needs or those who are physically unwell at the time of the study.
  • Receipt of professional dental prophylaxis within the previous 3 months.(Tavargeri & Banerjee, 2021)
  • Patient with a cariogenic diet.(Fouad et al., 2022)

• For the adult group:

  • Currently undergoing orthodontic treatment (fixed or removable appliances).
  • Individuals with physical disabilities or any systemic health conditions (e.g.,
  • diabetes) that could influence oral health or the ability to perform oral hygiene effectively.
  • Receipt of professional dental prophylaxis (e.g., scaling and polishing) within the previous 3 months.(Fageeh et al., 2024)
  • Patients with a cariogenic diet. (Fouad et al., 2022)

Individual participant data (IPD) will not be shared for the protection of participant confidentiality.