Use of a powered toothbrush to improve oral health in individuals with mild cognitive impairment.

Abstract

The aim of the study is to investigate whether the use of a powered toothbrush could maintain oral health by reducing the dental plaque (PI), bleeding on probing (BOP), and periodontal pocket depth (PPD) ≥4mm in a group of individuals with MCI and also if changes in oral health affect various aspects of quality of life. People with cognitive impairment tend to have poor oral hygiene and poorer Quality of life. In the present study, the participants were asked to use a powered toothbrush for at least 2min morning and evening and no restrictions were given against the use of other oral care products. The participant survey conducted at each examination demonstrated that 61.2% of participants at baseline claimed to have experience of using a powered toothbrush, 95.4% at 6months and 95% after 12months. At the same time, the use of manual toothbrushes dropped from 73.3% to 44.7% from baseline to the 12-month check-up. This shows that several participants continue to use the manual toothbrush in parallel with the powered toothbrush, but that there is a shift towards increased use of the powered toothbrush. Removal of dental biofilm is essential for maintaining good oral health. We investigated whether using a powered toothbrush reduces the presence of dental plaque, bleeding on probing and periodontal pockets ≥4mm in a group of older individuals with mild cognitive impairment. Two hundred and thirteen individuals with the mean age of 75.3years living without official home care and with a Mini-Mental State Examination (MMSE) score between 20 and 28 and a history of memory problems in the previous six months were recruited from the Swedish site of a multicenter project, Support Monitoring And Reminder Technology for Mild Dementia (SMART4MD) and screened for the study. The individuals received a powered toothbrush and thorough instructions on how to use it. Clinical oral examinations and MMSE tests were conducted at baseline, 6 and 12months. One hundred seventy participants, 36.5% women and 63.5% men, completed a 12-month follow-up. The use of a powered toothbrush resulted, for the entire group, in a significant decrease in plaque index from 41% at baseline to 31.5% after 12 months (P<.000). Within the same time frame, the values for bleeding on probing changed from 15.1% to 9.9% (P<.000) and the percentage of probing pocket depths ≥4mm from 11.5% to 8.2% (P<.004). The observed improvements in the Oral Health Impact Profile 14 correlate with the clinical improvements of oral health. The use of a powered toothbrush was associated with a reduction of PI, BOP and PPD over 12months even among individuals with low or declining MMSE score. An adequately used powered toothbrush maintain factors that affect oral health and oral health-related Quality of Life in people with mild cognitive impairment.