Guide v powered toothbrushing in adolescent orthodontic sufferers – trial

The 2014 Cochrane overview by Yaacob et al (Dental Elf – 18th Jun 2014) introduced proof of a small profit for powered over handbook toothbrushing in decreasing plaque and gingivitis. Nevertheless solely a small variety of research included within the overview had been performed on orthodontic sufferers and these had been of a brief period. Consequently, the Cochrane reviewers instructed extra research of an extended period utilizing a standardised methodology.

The purpose of this examine was to match the efficacy of a powered versus handbook toothbrushing for controlling plaque and gingival well being in individuals present process fastened orthodontic remedy in respect of each the brief time period and long run.


This was a randomised, parallel, managed single-blind medical trial, undertaken in a hospital setting. Examine sufferers had been drawn from 12–18-year-olds about to begin complete orthodontic remedy, with a pre-adjusted edgewise fastened home equipment. Moral approval was obtained, and the trial registered with the Worldwide Commonplace Randomised Managed Trials Quantity (ISRCTN) registry.

Pattern measurement was calculated to detect a full mouth plaque rating discount of 0.25. Sufferers had been randomised to both a handbook or powered toothbrush, with allocation concealment with oral hygiene instruction being offered by a analysis nurse independently. Sufferers had been instructed to brush their enamel twice each day (within the morning and at bedtime) for at least 2 min with the fluoridated toothpaste was provided and inspired to make use of an orthodontic interspace brush. Plaque index (PI), gingival index (GI), and bleeding on probing (BoP) had been recorded. The Turesky modification of the Quigley–Hein plaque index was used for plaque scores and the Löe and Silness gingival index for gingival scores. Scores had been recorded by 2 skilled and calibrated researchers at baseline, 1 month, 6 months and 1 12 months together with an oral mushy and laborious tissue security evaluation.


  • 92 sufferers had been randomised at baseline, 46 every to handbook and powered toothbrushes teams.
  • At 12 months there have been 6 dropouts within the handbook group and a couple of within the powered toothbrush group.
  • There have been no important variations had been seen between powered and handbook toothbrushes between GI, PI and BoP at any of the time factors assessed: –
    • GI [gingival index] = -0.03 (95percentCI: −0.1 to 0.03).
    • PT [plaque index] = 0.01 (95percentCI: −0.13 to 0.14).
    • BoP [bleeding on probing] = 0.003 (95percentCI: -0.03 to 0.03).
  • Periodontal well being indicators and plaque management considerably worsened, over the 12-month follow-up interval, following placement of the fastened home equipment placement.
  • No harms had been reported or noticed because of both intervention and no sufferers had been faraway from the examine as a result of their oral hygiene proved to be unsatisfactory,


The authors concluded: –

No variations have been discovered between a handbook and sonic- powered toothbrush in controlling plaque and gingival well being in individuals present process fastened orthodontic remedy in both the brief time period or long run.


The authors registered their trial with the ISRCTN medical trial registry  and adopted the CONSORT tips.  A pattern measurement calculation was undertaken based mostly on the quantity required to detect a distinction in full mouth plaque rating of 0.25, indicating a complete pattern measurement of 80 sufferers. A computerised randomisation sequence was used with allocation concealment. The end result assessors had been skilled and calibrated and masked to the allocation with assessments going down at 4 time factors the newest at 12 months. Whereas the outcomes demonstrated no variations between powered and handbook toothbrushes the sufferers did deteriorate over the follow-up interval which can point out a necessity to enhance oral well being behaviours in each adolescents on the whole and people present process orthodontic remedy particularly. This trial was undertaken in a single hospital setting utilizing one specific sort of powered toothbrush so will not be generalisable so extra research in main care settings could also be useful.


This examine obtained funding help from Colgate-Palmolive (USA)


Main Paper  

Johal A, Shagmani M, Alfuraih O, Arad I. Lengthy-term comparability of the efficacy of handbook versus powered tooth brushing in adolescent orthodontic sufferers: a single-centre, parallel design randomized medical trial. Eur J Orthod. 2023 Sep 14:cjad042. doi: 10.1093/ejo/cjad042. Epub forward of print. PMID: 37708303.

Worldwide Commonplace Randomised Managed Trials Quantity (ISRCTN) 37708303

Different references

Dental Elf – 4th Nov 2022

Powered toothbrushes for sufferers present process fastened orthodontic equipment remedy?

Dental Elf – 15th Dec 2017

Powered toothbrushes for orthodontic sufferers

Dental Elf – 18th Jun 2014

Powered toothbrushes lowered plaque and gingivitis greater than handbook toothbrushes

Image Credit

Picture by Henrik Lagercrantz on Unsplash


Supply hyperlink
We will be happy to hear your thoughts

Leave a reply