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

Abstract

Introduction: 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. Methods: 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. Results: 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). Conclusions: An interactive power toothbrush generated increased brushing times and significantly greater plaque removal versus a manual brush.