The efficacy of manual toothbrushes in patients with fixed orthodontic appliances: a randomized clinical trial

• Published in: BMC oral health 2023-05, Vol.23 (1), p.315-8, Article 315
• Main Authors: Farook, Fathima Fazrina, Alrumi, Abdulmajeed, Aldalaan, Khaled, Ababneh, Khansa, Alshammari, Abdulsalam, Al-Khamees, Amani Abdullah, Albalawi, Farraj
• Format: Article
• Language: English
• Subjects: Adolescent; Biofilms; Care and treatment; Clinical trials; Control; Dental care; Dental caries; Dental hygiene; Dental plaque; Dental Plaque - prevention & control; Diagnosis; Disease prevention; Female; Fluorides; Health aspects; Humans; Hygiene; Identification and classification; Male; Management; Microbial mats; Mouth; oral health; Oral Hygiene; Orthodontic appliances; Orthodontic Appliances, Fixed; Orthodontics; Patients; Periodontal disease; plaque control; Plaque index; prevention; Statistical analysis; Systematic review; Teeth; toothbrush; Toothbrushes; Toothbrushing; Toothpaste; Young Adult
• ISSN: 1472-6831; 1472-6831
• DOI: 10.1186/s12903-023-03035-6

This study aims to evaluate three types of manual toothbrushes [Cross action (CA), Flat trim (FT), and orthodontic type (OT)] in terms of efficacy in plaque removal in patients undergoing fixed orthodontic treatment. Manual toothbrushes are an essential part of oral hygiene for primary prevention. Plaque control, however, can be influenced by a number of individual and material-related factors. Individual factors include the presence of fixed orthodontic appliances on tooth surfaces, such as brackets and bands, which create difficulties with oral hygiene and lead to plaque formation. The evidence for the effectiveness of advanced bristle designs (multilevel, criss-cross) of the manual toothbrush alone in removing plaque in patients undergoing orthodontic therapy is limited. The experiment followed the Consolidated Standards of Reporting Trials (CONSORT) guidelines. This was a three treatment, three-period crossover clinical trial with a single brushing exercise. Thirty subjects were randomized to one of the three treatment sequences of different bristle designs: (CA, FT, and OT). The primary outcome measure was the difference in the plaque scores (baseline minus post-brushing) at each study period, as determined by the Turesky-Modified Quigley-Hein Plaque Index. Of the thirty-four subjects enrolled in the study, thirty of the subjects met the inclusion criteria and completed all three periods of the study. The mean age was 19.5 ± 1.52 years, with a range of 18-23 years. The differences between treatments in plaque score reduction after brushing were statistically significant (p-value