We all know how important it is to maintain good oral hygiene during orthodontic treatment with fixed appliances. Many products have been suggested to help our patients in this regard. Such as, for instance, electronic toothbrushes… But do electronic toothbrushes provide better results than traditional toothbrushes?
An interesting study that answers this question was done at Queen Mary University of London. It was published last month in the European Journal of Orthodontics. Precisely on my birthday. Let’s have a closer look.
In their introduction, the authors highlighted that the majority of similar studies were either done on non-orthodontic patients, or were of very limited duration.
As a result, the aim of this new study was to evaluate both short term and long term differences in the efficacy of powered versus manual toothbrush.
The authors randomly allocated 46 participants to each group with the following inclusion criteria:
- Age 12-18 years at the start of treatment
- Brushed at least twice a day
- Good general health and a non-smoker
They compared three primary outcomes: mean gingival index, mean bleeding on probing, and mean plaque index. The assessment was done at baseline, in 1 month, in 6 months, and in 12 months.
The authors concluded:
“No differences have been found between a manual and sonic-powered toothbrush in controlling plaque and gingival health in participants undergoing fixed orthodontic treatment in either the short term or long term.”
This reinforces the findings of a systematic review which included studies of short duration. It was published 3 years ago in the American Journal of Orthodontics. [1]
My thoughts
It think that we should not recommend our patients expensive electronic toothbrushes as a solution for oral hygiene improvement. What we should do instead is to give them precise instructions on how to use manual toothbrushes and explain what potential damages poor oral hygiene can cause.
A great piece of advice I heard once from Dr. Neal Kravitz is that you take a toothbrush and clean patient’s teeth yourself, so that the patient learns what amount of pressure should be applied.
My own trick is a picture of white spot lesions on the flip side of my hand mirrors. While I am giving oral hygiene instructions I ask the patient to look in the mirror on his/her teeth. When I finish, I tell the patient: “now flip the mirror to see what happened to one unfortunate patient who dismissed the instructions.”
This is the actual picture which I have. You can print it and use it. Chances are it is more effective than an electronic toothbrush.
Orthodontic Grammar 