Power Toothbrush Research Articles

Comparison Between Powered and Manual Toothbrushes Effectiveness for Maintaining an Optimal Oral Health Status.

This integrative literature review evaluates the effectiveness of power toothbrushes (PTBs) compared to manual toothbrushes (MTBs) across various populations, focusing on plaque removal, gingival health, calculus reduction, and stain removal. PTBs equipped with advanced technologies such as oscillating-rotating and high-frequency sonic mechanisms have been examined for their potential to enhance oral hygiene. Special attention is given to vulnerable groups, including the elderly and individuals with intellectual disabilities, to assess how PTBs meet their specific oral health needs. A comprehensive literature search was conducted in databases including PubMed, Cochrane Library, Embase, and Google Scholar using keywords such as "power toothbrush", "electric toothbrush", "manual toothbrush", "plaque removal", "gingivitis", "calculus", "dental stains", "oral hygiene", "elderly", and "intellectual disabilities". Studies published between 2000 and 2024 were selected based on their relevance to the PTB and MTB comparison, with an emphasis on outcomes related to oral hygiene efficacy. As this review is narrative rather than systematic, it focuses on synthesizing existing knowledge without applying strict inclusion or exclusion criteria. The results indicate that PTBs generally outperform MTBs in reducing plaque, gingivitis, and stains, though the benefits for special populations are less pronounced but still significant. However, practical issues such as user experience and mechanical reliability of PTBs warrant further investigation. In conclusion, this review enhances the understanding of PTB effectiveness, guides consumer choices, and informs future technological advancements in dental care practices.

Effect of a powered and a manual toothbrush in subjects susceptible to gingival recession: A 36-month randomized controlled clinical study.

The objective of this long-term clinical study was to evaluate the influence of a newly developed powered toothbrush (PT) on the size and number of pre-existing gingival recessions (GR) in comparison to a manual toothbrush (MT). This was a prospective, single-blind, parallel-group, randomized controlled clinical study. Participants without periodontitis, but with at least two teeth (index teeth) showing GR ≥2 mm were randomized to brush either twice daily with a MT or with a PT with a linear magnetic drive causing the round brush head to produce gentle micro vibrations along with oscillating-rotating movements. Primary outcome parameter was the mean change of GR at the index teeth over 36 months. Totally 87 out of 92 participants completed the study (MT/PT: n = 42/n = 45). At the 36-month evaluation the mean (standard deviation) change of GR at index teeth differed significantly between MT 0.17 (0.77) and PT -0.10 (0.63) (p = 0.013). Furthermore, the amount of GR sites which improved ≥1 mm or remained stable during the study period did not differ between MT and PT, but the number of sites worsened ≥1 mm was significantly in favour for PT (MT 23 (25.5%) versus PT 10 (10.6%); p = 0.009). A binary logistic regression identified tooth type (OR = 2.991 for pre-/molar (1.096 [95% CI 1.002-8.933]; p = 0.050)) and manual brushing (OR = 3.341 (1.206 [95% CI 1291-8648]; p = 0.013)) as risk factors for recession impairment at the index teeth. There were no differences between groups for adverse events. In a population with pre-existing gingival recessions and consequently a high risk of developing further recession the PT seems to be favourable with regard to further development of GR.

Comparative evaluation of effects of manual and powered tooth brushing on biofilm formation on metal orthodontic brackets and on gingival and periodontal health- an in-vivo study

To evaluate and compare the effects of manual tooth brushing and powered tooth brushing on biofilm formation on metal orthodontic brackets and on gingival and periodontal health of the patient undergoing orthodontic treatment.This randomized controlled clinical trial comprised a total of 36 patients in the age group 15-25 years, coming to Outpatient Department (OPD) of Orthodontics and Dentofacial Orthopedics and undergoing orthodontic treatment. Periodontal evaluation was performed for each patient at four intervals of time, before oral prophylaxis, 1 week after oral prophylaxis, after 3 months of bonding and after 6 months of bonding which constituted the readings at T, T, T and T, respectively. Patients were instructed to use manual toothbrushes for 3 months after bonding. Post 3 months, the patients were divided into two groups- Group I and II as Group I- patients using powered toothbrush and Group II- patients using manual toothbrush, for next 3 months. At both the intervals (T and T), two brackets were debonded from central incisors and second premolars from each patient and studied under scanning electron microscope for biofilm formation.Powered toothbrushing was more effective in reducing API and SBI scores, statistically high significant difference was seen in API score (P = .004) and SBI score (P < .001) between T & T time intervals on comparing both the groups. Both the manual and powered toothbrushing had equal effect on GI scores, no significant difference was seen in GI score (P = .540) between T & T time intervals on comparing both the groups. On inter group comparison of amount of biofilm formation between T2 & T3 time intervals in anterior and posterior region, higher amount of biofilm formation in both the anterior and posterior regions in group II patients (Anterior region= 12.05±6.90, P = .001, posterior region= 10.32±9.75, P = .001).Powered toothbrushes are more effective in removing plaque and thus reducing gingival inflammation in patients with fixed orthodontic appliances.

The effects of scaling and root planing plus home oral hygiene maintenance in Stage I/II periodontitis population: A 24-week randomized clinical trial.

To compare the effects of powered and manual toothbrushing following scaling and root planing on bleeding on probing and other clinical indicators of periodontitis. This was a randomized, examiner-blind, parallel-design, 24-week clinical study. Eligible subjects were 18-75 years of age with Stage I or II periodontitis. All subjects received scaling and root planing (SRP) within 28 days of enrollment. Thereafter, subjects were randomized to twice daily at-home use of either a powered toothbrush (PTB) or a manual toothbrush (MTB). Randomization was balanced for gender and periodontitis stage. No other oral hygiene aids were permitted. Subjects were evaluated every 4 weeks for the following measures: bleeding on probing (BOP), surface plaque (MPI), probing pocket depth (PPD) and clinical attachment level until Week 24. Of 328 randomized subjects, 299 subjects completed the study. For BOP at Week 24, the Least Squares (LS) Mean, standard error (SE) reduction from baseline was 0.24 (0.01) for the PTB group and 0.02 (0.01) for the MTB group, resulting in a statistically significant treatment difference of 0.22 (0.01), p-value < 0.0001. There were also concomitant reductions in MPI and PPD at Week 24, resulting in statistically significant (p-value < 0.0001) LS Mean (SE) treatment differences of 0.86 (0.04) and 0.24 (0.01), for MPI and PPD, respectively. When combined with SRP, daily home oral hygiene maintenance including a powered toothbrush significantly reduced clinical symptoms of periodontitis and surface plaque levels compared to a manual toothbrush in a Stage I/II periodontitis population. (ClinicalTrials.gov Identifier: NCT04254770).

Manual vs. interactive power toothbrush on plaque removal and salivary Streptococcus mutans and Lactobacillus casei levels : Single-center, examiner-blinded, randomized clinical trial in orthodontic patients.

The purpose of this study was to compare efficacy of amanual and an interactive power toothbrush in orthodontic patients by assessing periodontal indexes and bacterial content of saliva samples. Forty patients (20females, 20males; age range 12-18years) with fixed orthodontic appliances were included in the study. The patients were randomly divided into two groups in a1:1 ratio using sealed envelopes: group1: manual toothbrush (Oral‑B Ortho Brush, Procter&Gamble Company, Dublin, Ireland), group2: interactive power toothbrush (Oral‑B Genius 8900, Procter&Gamble Company, Marktheidenfeld, Germany). All participants were given the same toothpaste (Colgate Triple Action, Colgate-Palmolive, New York, NY, USA). The brushing procedure for each patient was described in detail, both orally and visually, utilizing avideo demonstration. Plaque and bleeding index scores were recorded for both the lower and upper arches at the beginning of the study (T0) and at weeks6 (T1) and 12 (T2). In addition, the numbers of Streptococcus (S.)mutans, Lactobacillus (L.)casei, and Porphyromonas (P.)gingivalis bacteria were determined using areal-time polymerase chain reaction (PCR) analysis in saliva samples collected at T0, T1, and T2 times. Mann-Whitney U test and Student's ttest were used to compare data between the groups, and one-way analysis of variance (ANOVA) and Friedman tests were used to compare data from different time intervals for each group. Plaque index values were greater in group1 at T1 and T2, although there was no difference between the groups at T0. The gingival index scores of both groups were similar at T0, T1, and T2. While group2 had alarger number of salivary S.mutans at T0 and T2, there was no significant difference between the groups at T1. At all three time points, there was no significant difference in salivary L.casei levels between the groups. Although the interactive power toothbrush was more effective at removing plaque than the manual toothbrush, the results of the gingival index did not reflect the plaque scores. The number of certain salivary bacteria and brush type did not appear to have aclear relationship.

Investigation of the effects of Bipolar Radiofrequency Energy on the Structural Morphology of Dental Plaque.

To investigate the effects of radiofrequency (RF) energy, applied through a power toothbrush, on the structural morphology of dental plaque and its bacteria components. Previous studies showed that a toothbrush powered by RF (ToothWave) effectively reduces extrinsic tooth stains, plaque, and calculus. However, the mechanism by which it reduces dental plaque deposits is not fully established. Multispecies plaques at sampling time points of 24, 48, and 72 hours were treated with the application of RF using ToothWave with the toothbrush bristles 1 mm above the plaque surface. Groups that underwent the same protocol but without RF treatment served as paired controls. Confocal laser scanning microscope (CLSM) was used to determine cell viability at each time point. Plaque morphology and bacteria ultrastructure were viewed using scanning electron microscope (SEM) and transmission electron microscope (TEM), respectively. Data were analyzed statistically using analysis of variance (ANOVA) and Bonferroni post-tests. At each time, RF treatment significantly (p < 0.05) reduced the viable cells in plaque and caused a substantial disruption of plaque morphology, while the untreated plaque had intact morphology. Cells in treated plaques showed disrupted cell walls, cytoplasmic material, huge vacuoles, and heterogeneity in electron density, while these organelles remained intact in untreated plaques. The application of RF via a power toothbrush can disrupt plaque morphology and kill bacteria. These effects were enhanced by the combined application of RF and toothpaste.

Effect of laser bleaching, ultrasonic scaling and powered tooth brushing on surface roughness and bacterial adherence of class V composite restorations.

To evaluate and compare the effect of diode laser assisted bleaching, ultrasonic scaling and powered tooth brushing on surface roughness and bacterial adherence on class V cavities restored with composites. A total of one hundred and twenty samples (40 samples each of Brilliant Everglow, Beautifil II and Heytec-N) were prepared in standardized stainless steel molds. The samples were further subdivided into four subgroups i.e. one control group (without any intervention) and three experimental groups - diode laser assisted bleaching, ultrasonic scaling and powered tooth brushing consisting of 10 sample each. Surface roughness was measured quantitatively with the help of 3D Optical Profilometer. For bacterial adherence analysis S. mutans strain (ATCC 25175) was cultured in BHI medium and samples were evaluated for the presence of viable bacteria using the Colony Forming Unit (CFU) count. Results obtained were then tabulated and subjected to statistical analysis. Diode laser bleaching caused a significant increase in surface roughness and bacterial adherence with lowest mean change exhibited by Heytec-N followed by Beautifil II and highest by Brilliant Everglow group. Similarly, Ultrasonic scaling increased the surface roughness of all the three tested samples with significant difference between the groups. Powered tooth brushing had no effect on the surface roughness and bacterial adherence of the tested composites. Diode assisted laser bleaching and ultrasonic caused significantly higher surface roughness and bacterial adherence values for all the tested composites. It may therefore be recommended to do finishing and polishing of restorations after such procedures.

Evaluation of an advanced oral hygiene regimen on maternity outcomes in a randomized multicenter clinical trial (Oral Hygiene and Maternity Outcomes Multicenter Study)

During pregnancy, dental plaque-induced gingivitis prevalence and subsequent risk of periodontal disease increases substantially as a consequence of both inadequate oral hygiene and changes in sex steroid hormone levels. Although maternal periodontal disease has been associated with adverse pregnancy outcomes, including spontaneous preterm birth, previous clinical trials involving mechanical debridement (e.g., scaling and root planing) to remove plaque biofilm have not yielded decreased rates of preterm birth. We hypothesized that an advanced oral hygiene program, including an antibacterial regimen coupled with a power toothbrush and hygiene instruction, may improve the periodontal milieu and reduce the rate of spontaneous preterm birth. Therefore, we conducted a clinical trial of obstetrical patients with moderate-to-severe gingivitis who were randomized to an advanced oral hygiene program versus usual oral hygiene care, and the primary obstetric outcome compared between the treatment groups was gestational age at delivery. Obstetrical patients with singleton pregnancies between 8 and 24 weeks gestation were screened by trained dentists at two clinical sites for moderate-to-severe gingivitis (more than 30 intra-oral sites with gingival bleeding on probing). Eligible participants were randomized to an advanced oral hygiene regimen, including antibacterial mouth wash, dental floss, antibacterial toothpaste, a power toothbrush, and intensive oral hygiene education versus standard oral home care instructions and regimen. The primary obstetric outcome assessed was gestational age at delivery. The overall primary (dental) outcomes were gingival index, bleeding sites, and pocket depth (reported elsewhere). Secondary obstetric outcomes included birthweight and incidence of preterm birth at <37 weeks. Regression models were utilized and included factors such as treatment group, gestational age at enrollment, preterm birth history, and potential markers of health disparities (i.e., education, employment status). A total of 817 obstetrical patients underwent dental screening at the two sites, 789 were identified with moderate-to-severe gingivitis, 746 were randomized, and birth outcomes were available for 613 of the study participants. The gestational age at delivery was two days earlier in the control group (p=0.040), but the clinical significance of this finding was limited (39.13 vs 38.85 weeks). Overall rates of spontaneous preterm birth <37 weeks and <34 weeks were not statistically different between the two treatment groups (7.0% advanced oral hygiene regimen versus 10.3% controls, OR=1.63 (0.90, 3.00), p=0.11; and 2.3% versus 3.9%, OR=1.88 (0.71, 4.98), p=0.20, respectively). However, we observed lower rates of spontaneous preterm birth among unemployed participants with less favorable socioeconomic status (4.7% advanced oral hygiene regimen versus 16.0% controls, OR=4.04 (1.34, 15.12), p=0.01). An advanced oral hygiene program may reduce the risk of spontaneous preterm birth among pregnant patients with moderate-to-severe gingivitis and health disparities. This is the same group that may be at highest risk of poor dental hygiene and preterm birth.

Effects of brushing duration on the efficacy of dental plaque removal: An in vitro study.

This study was performed to evaluate the effects of varying brushing times on the dental plaque-removal efficacy of a power toothbrush to determine the optimal length of time required to brush the teeth. A typodont with 32 teeth was divided into four quadrants and further divided into four zones each (two teeth per zone). Using a robotic arm, toothbrushing was performed over eight different brushing times (0, 60, 120, 180, 240, 300, 360, and 420 s) to remove the artificial plaque applied on the labial surface of the teeth in occlusion. Photographs were taken every 60 s from each zone of the typodont. The images obtained were processed using ImageJ software to measure the percentage of remaining plaque. Data were analysed with factorial ANOVA, least squares regression analysis, and post hoc Tukey tests. Plaque removal significantly increased with brushing time across the brushing intervals studied (p < 0.05). Efficient plaque removal was achieved after 240 s of brushing. There was no significant difference in plaque accumulations between the maxillary and mandibular arch (p = 0.19) and the right and left areas after each time interval (p = 0.49). Brushing duration is negatively correlated with the remaining plaque for a given toothbrush. Two minutes of brushing is not sufficient for significant plaque removal. Considering the limitations of this in vitro study, clinical studies are needed in order to change brushing recommendations to 240 s.

Powered tooth brushes are beneficial for long-term oral health: Results from the Study of Health in Pomerania (SHIP-TREND).

To determine the long-term effects of the use of powered tooth brush (PTB) in comparison to manual tooth brush (MTB) on periodontitis severity, coronal caries experience, and the number of missing teeth using in a population-based cohort study. Using 7-year follow-up data of 2214 participants of the Study of Health in Pomerania (SHIP-TREND), comprehensively adjusted linear models using generalized least squares and ordinal regression models estimated the effects of PTB usage on dental outcomes in complete case and imputed data. At follow-up, PTB users had lower medians for mean probing depth (PD; 2.21 mm) and mean clinical attachment levels (1.73 mm) than MTB users (2.30 and 1.96 mm, respectively). Adjusted models revealed the beneficial effects of PTB usage on follow-up levels of plaque, bleeding on probing, mean PD, percentage of sites with PDs ≥4 mm, mean clinical attachment levels (all, interdental, and non-interdental sites, respectively), and the number of missing teeth. For the number of missing teeth, the effects were more pronounced in participants aged ≥50 years. No significant effects of PTB usage on the number of decayed or filled surfaces (all and interdental sites) were found. A recommendation of PTB usage in dental practice could contribute to the long-term promotion of oral health.

Effect of ozone irrigation and powered toothbrushing on dental plaque, gingival inflammation, and microbial status in institutionalized mentally challenged individuals: A double-blinded, randomized, controlled clinical trial.

This study compares and evaluates the efficacy of ozonated water irrigation (OZI) and powered toothbrushing on the oral health and microbial status of mentally challenged individuals. Thirty individuals of age range 15-30 years with a mild-to-moderate level of mental retardation (MR) and gingival inflammation participated in this double-blind randomized controlled clinical trial. Total duration of the study was 45 days consisting of two clinical phases (phase I, i.e., aided) and phase II, i.e. unaided) of the duration of 21 days in each phase, with a washout period of 3 days between the two phases. With a split-mouth design, sites from each subject were randomly allocated into two treatment groups: Powered Toothbrushing (PB) and OZI were randomly done for each half side of the mouth of each subject. Subgingival plaque samples were collected from sites of both the treatment groups and sent for microbial analysis. Clinical and microbial parameters were measured before and after the treatment. Significant improvement of the clinical and microbial parameters was found in both treatment groups. However, intergroup differences in the parameters were statistically nonsignificant. OZI could serve as an alternative or adjunct to powered toothbrushes for people with MR.

Effectiveness of Oscillating and Rotating versus High-Frequency Sonic Powered Toothbrush in Dental Hygiene University Students: A Proof-of-Concept Study

Plaque biofilm is considered one of the etiological factors involved in the onset of caries and gingivitis, and is associated with the progression of periodontitis and peri-implant inflammation. There is no agreement in the literature on the effectiveness of the oscillating-rotating (OR) powered toothbrush (PTB) and high-frequency sonic (HFS) PTB in improving oral health. Thus, using the present proof-of-concept study we aimed to evaluate the effectiveness of OR PTB versus HFS PTB in terms of the improvement in plaque, gingival inflammation, and lingual patina indexes in dental hygiene university students. Dental hygiene students from the University of Eastern Piedmont “A. Avogadro” of Novara, Italy from November 2019 to October 2021 were recruited. Based on the type of toothbrush previously used for at-home plaque removal, the study participants were divided into two groups: Group 1 (subjects that used MTB prior to the study beginning, asked to use OR PTB for 2 times/day for a minimum of 3 months) and Group 2 (subjects that used HFS PTB prior to the study beginning). All the participants were instructed to avoid floss aids during the study (i.e., pipe cleaners, dental floss, and mouthwash). The outcome measures were: New Method of Plaque Scoring (NMPS), simplified Oral Disease Index (OHI-S), Plaque Control Record (PCR), Gingival Bleeding Index, and Winkel Tongue Coating Index (WTCI). All the outcomes were assessed at baseline (T0) in both groups and after 3 months (T1) in Group 1. Fifty-seven subjects (44 females and 13 males) were included and allocated to the study group (n = 30, 22 females and 8 males) and control group (n = 27, 22 females and 5 males). At T0, all the indexes were significantly higher in Group 2 (p &lt; 0.0001). At T1, NMPS, OHI-S, PCR, GBI, and WTCI were statistically improved in Group 1 (p &lt; 0.0001). Lastly, there was a statistically significant difference between Group 1 at T1 and Group 2 at T0 in terms of NMPS (p = 0.043), OHI-S (p = 0.032), and PCR (p &lt; 0.001). Taken together, the findings of this proof-of-concept study showed the effectiveness over a 3-month period of both oscillating-rotating and sonic PTB in terms of oral health status in a sample of dental hygiene students.

Manual and Powered Tooth Brushing Behaviors

Manual and Powered Tooth Brushing Behaviors

The efficacy of an oscillating-rotating power toothbrush compared to a high-frequency sonic power toothbrush on parameters of dental plaque and gingival inflammation: A systematic review and meta-analysis.

To establish the efficacy of oscillating-rotating power toothbrush (OR-PTB) compared to high-frequency sonic power toothbrush (HFS-PTB) on improving parameters of plaque and gingival inflammation. Safety and participants' preference were secondary interests. MEDLINE-PubMed and Cochrane-CENTRAL databases were searched, up to April 2021. Inclusion criteria were (randomized)controlled clinical trials that evaluated healthy humans brushing with an OR-PTB compared to a HFS-PTB. Evaluation for a minimum of 4 weeks, of one or more of the following parameters: plaque index scores (PI), bleeding scores (BS), number of bleeding sites (NoB) and gingival index scores (GI). Thirty two publications involving 38 comparisons were included after the independent screening. The descriptive analysis showed that in 54% of the comparisons, a significant difference in favour of the OR-PTB was found for PI, BS and GI scores. The Quigley and Hein index showed a significant difference of means (DiffM) between the end scores (DiffM 0.13, 95% CI [0.05;0.21] p < 0.001), as well as for the Rustogi-modified Navy index (DiffM 0.01, 95% CI [0.01;0.03] p=0.002). This is in line with the meta-analysis for BS (DiffM 0.09, 95% CI [0.03;0.14] p=0.003), for which the results were in favour of the OR-PTB and considered potentially clinically relevant. NoB showed a significant difference in favour of the OR-PTB for the end scores (DiffM 3.61, 95% CI [2.63;4.58] p < 0.00001). No difference in safety was indicated, 78% of participants preferred the OR-PTB. For patients to maintain good plaque control and improve gingival health, there is a small but significant difference based on longer-term studies between OR-PTB and HFS-PTB. This difference is potentially clinically relevant.

Effects of interactive power toothbrush with or without application assistance on the plaque, gingivitis, and gingival abrasion among dental students: a randomized controlled clinical trial.

The purpose of this randomized controlled study is to determine if an interactive power toothbrush (PTB) with application (app) promotes additional benefit on dental plaque, gingivitis, and gingival abrasion to that of a manual toothbrush (MTB). Ninety participants (dental students) diagnosed with gingivitis were randomly assigned, into three groups, 1:1:1 ratio, given an app-assisted interactive PTB (PTB-A) (Oral-B Genius® Rechargeable 8000 PTB with CrossAction brush head) or the same PTB without app-assistance (PTB-NA) or a regular MTB for home-use. Plaque was assessed using the Turesky modification of the Quigley and Hein Plaque Index (QHPI-TM), and gingivitis was evaluated using the Bleeding on Marginal Probing Index (BOMP) at baseline (T0), week 2 (T1), and week 8 (T2). Gingival abrasions were recorded at T1 and T2. Exit survey was used to assess brushing time and visual-analogue-scale (VAS) scores. PTB improved QHPI-TM significantly in terms of time-dependent changes, irrespective of app-assistance. BOMP was observed to be statistically lower in PTB-A than in MTB only at T2. Brushing times were longer in PTB-A than in MTB. Gingival abrasion was less in both PTB than MTB. PTB-A had better results to MTB in cleaning ability according to subject-reported outcomes. Both PTBs were more effective to MTB; however, the app-assisted interactive PTB was similar to the non-assisted one in plaque removal efficacy, gingivitis reduction, and incidence of gingival abrasion, yet better than MTB in cleaning ability. Developing an application software to prevent gingival abrasion might be clinically beneficial regardless of the individual factor. ClinicalTrial.gov ID: NCT05150132.

A naturalistic study of brushing patterns using powered toothbrushes.

Dental caries and periodontal disease are very common chronic diseases closely linked to inadequate removal of dental plaque. Powered toothbrushes are viewed as more effective at removing plaque; however, the conflicting evidence and considerable unexplained heterogeneity in their clinical outcomes does not corroborate the relative merits of powered tooth brushing. To explain the heterogeneity of brushing patterns with powered toothbrushes, we conducted a observational study of tooth brushing practices of 12 participants in their naturalistic setting. Integrated brush sensors and a digital data collection platform allowed unobtrusive and accurate capture of habitual brushing patterns. Annotated brushing data from 10 sessions per participant was chosen for scrutiny of brushing patterns. Analysis of brushing patterns from the total 120 sessions revealed substantial between- and within-participant variability in brushing patterns and efficiency. Most participants (91.67%) brushed for less than the generally prescribed two minutes; individual participants were also inconsistent in brushing duration across sessions. The time devoted to brushing different dental regions was also quite unequal. Participants generally brushed their buccal tooth surfaces more than twice as long as the occlusal (2.18 times longer (95% CI 1.42, 3.35; p < 0.001)) and lingual surfaces (2.22 times longer (95% CI 1.62, 3.10; p < 0.001); the lingual surfaces of the maxillary molars were often neglected (p < 0.001). Participants also varied in the epochs of excessive brushing pressure and the regions to which they were applied. In general, the occlusal surfaces were more likely to be brushed with excessive pressure (95% CI 0.10, 0.98; p = 0.015). Our study reveals that users of powered toothbrushes vary substantially in their use of the toothbrushes and diverge from recommended brushing practices. The inconsistent brushing patterns, between and within individuals, can affect effective plaque removal. Our findings underscore the limited uptake of generic oral self-care recommendations and emphasize the need for personalized brushing recommendations that derive from the objective sensor data provided by powered toothbrushes.

Plaque removal by a novel prototype power toothbrush versus a manual toothbrush: A randomized, exploratory clinical study.

ObjectivesThis exploratory study investigated plaque removal with a prototype constant, low rotation speed Power Toothbrush (PTB) with two brushing actions: “Gumline” (head rotates in the horizontal axis) and “Interdental” (head rotates in the vertical axis). Gumline alone and “Combined” (Gumline + Interdental) modes were compared with a Reference PTB and a Reference Manual Toothbrush (MTB) after one brushing.Materials and MethodsThirty‐nine participants were randomized to use each toothbrush once either in the sequence (A) Prototype PTB (in Gumline then Combined mode), (B) reference MTB, and (C) reference PTB or the sequence BAC. There was a minimum 3‐day washout between the use of each toothbrush. Plaque removal was measured using the Rustogi Modified Navy Dental Plaque Index (RMNPI) with change from baseline investigated using an analysis of covariance model. RMNPI scores were calculated on a “whole mouth” basis and along the gingival margin and at proximal sites only.ResultsFor the primary efficacy variable, a significant difference was found in favor of the prototype PTB in gumline mode versus the reference MTB for whole mouth plaque score (difference: −0.06; standard error: 0.014; 95% confidence interval [CI] −0.09 to −0.04; p < .0001). Similar significant differences were found in gingival margin and proximal areas (p < .0001). The prototype PTB in gumline mode removed significantly less plaque than the prototype PTB in combined mode and the reference PTB (p < .0001; whole mouth/gingival/proximal areas). The prototype PTB in combined mode removed significantly more plaque than the reference MTB (p < .0001; whole mouth/gingival/proximal areas) and the reference PTB for whole mouth (p = .0214) and gingival margin areas (p = .0010). The reference PTB also removed significantly more plaque than the reference MTB (p < .0001; whole mouth/gingival/proximal areas). All brushes were generally well‐tolerated.ConclusionThe prototype PTB design, providing two distinct cleaning modalities, can effectively remove plaque to a significantly higher degree than an MTB and a marketed PTB, depending on mode.

Change in oral hygiene behaviour after non-surgical periodontal therapy - A retrospective analyses.

This retrospective analysis investigates changes in daily oral hygiene behaviour after the initial phase of non-surgical periodontal therapy (NSPT). This retrospective study includes 189 consecutive periodontitis patients treated for moderate to severe periodontitis. The authors used the oral hygiene behaviour questionnaire (OHB-9) to assess and evaluate the oral hygiene self-care practices at both intake and evaluation after an active phase of NSPT which consisted of repeated oral hygiene instruction (OHI), supra- and subgingival debridement and polishing. In addition, data on pocket probing depth and bleeding upon pocket probing (BOP) were extracted and PISA and PESA scores were collected. All these parameters are descriptive of the periodontal status at intake and the clinical response to NSPT. The OHB-9 showed an increased oral hygiene self-care level after the active phase of NSPT. At the evaluation, 85% of patients used a power toothbrush (PTB), representing an increase of 26% as compared with the intake. In addition, 64% reported brushing 3min or longer, representing an increase of 33%. The use of woodsticks (WS) and interdental brushes (IDB) at least once a day increased with 15% and 40% respectively. The distribution changes on the answering scale were significant for IDB, WS and brushing duration. However, no significant relationship was found between oral hygiene behaviour at the evaluation and the improvement of the gingival inflammation evaluated by BOP percentage. The finding of the OHB-9 questionnaire reported was an increase of patients who brushed longer and used the PTB, WS and IDB on a daily basis. The observed improvements in gingival inflammation assessed as bleeding on probing tendency were not significantly associated with oral hygiene behaviour at the evaluation of NSPT.

What characterizes effective tooth brushing of daily users of powered versus manual toothbrushes?

BackgroundRecent data show comparable deficits in oral cleanliness after tooth brushing in habitual users of powered toothbrushes (PT) and manual toothbrushes (MT). The present analysis explores the origin of these deficits by relating aspects of the observed tooth brushing behaviour to plaque after tooth brushing.MethodsUsers of rotating-oscillating PT (N = 48) and of MT (N = 52) brushed their teeth the best they could while being filmed. Video analyses assessed brushing time, number of sextants brushed sufficiently long (7.5 s per surface; NSBSL), brushing of outer surfaces with closed jaws, and brushing movements. Correlation analyses examined the relationship between these parameters and plaque after brushing (Marginal Plaque Index (MPI); Turesky modification of Quigley Hein Index (TQHI)) and gingivitis (Papillary Bleeding Index (PBI)).ResultsIn PT users, correlations between behaviour and MPI-scores were significant for the NSBSL (outer surfaces: rho = − 0.249; inner surfaces: rho = − 0.510) and brushing duration (outer surfaces: rho = − 0.399; inner surfaces: rho = − 0.509). In MT users, vertical movements on the outer surfaces were positively related to MPI (rho = 0.299). In contrast, circular movements correlated negatively with MPI in those who brushed all outer sextants sufficiently long (n = 47: rho = − 0.294). In both groups, PBI-scores on the inner surfaces were negatively correlated to NSBSL and brushing duration (rho = − 0.327 − rho = − 0.246).ConclusionNSBSL and brushing duration appear to play an important role for brushing effectiveness and gingival health in PT and MT users. Whether PT users apply brushing movements or not apparently does not affect the result. In MT users, circular movements seem to be more efficient than vertical movements on the outer surfaces.

Evaluation of the Efficacy of Manual Toothbrush Versus Power Toothbrush in Reduction of Gingivitis: A Comparative Clinical Study.

Background:In our study, we compare the power toothbrush with the manual toothbrush and the results showed were contradictory. Where few studies have reported that power toothbrushes are superior, other studies showed that both are equally efficacious in removing dental plaque.Aims:The present study was conducted to evaluate and compare the efficacy of manual toothbrush with an electric toothbrush in reducing dental plaque and gingivitis.Materials and Methods:The study included a total of 56 subjects which were randomly divided into two groups of 28 subjects each. At week 1, disclosing agent (two-tone solution) was used to detect plaque, and Loe and Silness Gingival Index were used to assess gingival scores. Oral hygiene instructions and brushing were also reinforced. A similar protocol was repeated at one, two, and six weeks. The collected data were subjected to statistical evaluation.Results:At two weeks, the plaque score for manual and power toothbrushes were 60.253 ± 20.672 and 44.031 ± 16.484, respectively, and this difference was statistically significant with P = 0.0020. At six weeks, plaque scores for manual and power toothbrushes were 43.784 ± 22.647 and 20.489 ± 10.336, respectively, and were statistically significant (P < 0.0001).Conclusion:The present study concludes that powered toothbrush has added advantages of improved oral hygiene compared to manual toothbrush concerning plaque reduction. This can be attributed to predefined power and force which can effectively remove plaque, calculus, and improved gingival health.