Comparative assessment of plaque removal and motivation between a manual toothbrush and an interactive power toothbrush in adolescents with fixed orthodontic appliances: A single-center, examiner-blind randomized controlled trial

• Published in: American journal of orthodontics and dentofacial orthopedics Vol. 155; no. 4; pp. 462 - 472
• Main Authors: Erbe, Christina, Klees, Violetta, Braunbeck, Fabienne, Ferrari-Peron, Priscila, Ccahuana-Vasquez, Renzo A., Timm, Hans, Grender, Julie, Cunningham, Pamela, Adam, Ralf, Wehrbein, Heinrich
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2019
• Subjects: Adolescent; Dental Plaque - prevention & control; Dental Plaque Index; Female; Humans; Male; Motivation; Orthodontic Appliances, Fixed; Single-Blind Method; Toothbrushing - instrumentation; Toothbrushing - psychology; Toothbrushing - statistics & numerical data
• ISSN: 0889-5406; 1097-6752; 1097-6752
• DOI: 10.1016/j.ajodo.2018.12.013

The objective of this 2-arm parallel trial was to determine the plaque removal efficacy (main outcome) and the motivation assessment (secondary outcome) comparing a manual versus an interactive power toothbrush in orthodontic patients. Sixty adolescents with fixed orthodontic appliances in both arches were randomized in a 1:1 ratio in this parallel, randomized, examiner-blind controlled clinical trial. Eligibility criteria included at least 16 natural teeth, 1-6 “focus care areas,” plaque score of ≥1.75, no severe caries, gingivitis and periodontitis, no dental prophylaxis, no smoking, no antibiotics, and no chlorhexidine mouth rinse. Subjects were to brush unsupervised with either an interactive power toothbrush (Oral-B Professional Care 6000, D36/EB20) with Bluetooth technology or a regular manual toothbrush (Oral-B Indicator 35 soft). Focus care areas were each brushed for 10 additional seconds. Plaque removal was assessed with the use of the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI) to determine change from baseline at 2 and 6 weeks. Supervised brushing at screening and post-treatment visits recorded actual brushing times. Subject-reported motivational aspects were recorded at screening and week 6. Fifty-nine subjects aged 13-17 years completed the study. The interactive power toothbrush provided significantly (P <0.001) greater plaque reduction versus the manual toothbrush at 2 and 6 weeks according to the whole-mouth TMQHPI. The treatment difference in adjusted mean plaque change from baseline was 0.777 (95% CI 0.614-0.940) at week 2 and 0.834 (0.686-0.981) at week 6. Mean reductions in the number of focus care areas were also significantly greater (P <0.001) in the power brush group at weeks 2 and 6. Brushing times increased significantly at weeks 2 and 6 (P ≤0.013) versus baseline in the interactive power brush group only. Subject-reported motivation was significantly increased in the interactive power brush group at week 6 versus screening (P ≤0.005). An interactive power toothbrush generated increased brushing times and significantly greater plaque removal versus a manual brush. •A power toothbrush with a smartphone application generated increased brushing times.•Compared with manual brushing, the interactive toothbrush removed more plaque.•Motivation to brush longer and more frequently increased in the interactive group.