The aim of the present study was to determine whether the type of toothbrush grip affects gingival injury during brushing. The cleanness of the teeth achieved by use of 2 different brush grips was also evaluated. The teeth of 13 dental nurse students were brushed by a dental hygienist. Using the split mouth technique, one side of the mouth was brushed for 2 min holding the toothbrush with a pen grip and the other side for another 2 min using the palm grip. The procedure was repeated 11 days later with reversed brush grips on the 2 sides of the jaws. More gingival injuries were found when the toothbrush was held with the palm grip than with the pen grip. This difference was statistically significant (P less than 0.01). No statistically significant difference were observed between corresponding plaque scores as measured according to the PLQ-index, irrespective of whether the plaque scores were presented as plaque remaining after experimental brushing or as the difference between the PLQ scores before and after brushing.