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Fulltext Powered versus manual toothbrushing for oral health

Yaacob M, Worthington HV, Deacon SA, Deery C, Walmsley AD, Robinson PG, et al.

Cochrane Database Syst Rev, 2014 Jun 17;2014(6):CD002281.
PMID: 24934383 DOI: 10.1002/14651858.CD002281.pub3

BACKGROUND: Removing dental plaque may play a key role maintaining oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this. This is an update of a Cochrane review first published in 2003, and previously updated in 2005.
OBJECTIVES: To compare manual and powered toothbrushes in everyday use, by people of any age, in relation to the removal of plaque, the health of the gingivae, staining and calculus, dependability, adverse effects and cost.
SEARCH METHODS: We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 23 January 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 1), MEDLINE via OVID (1946 to 23 January 2014), EMBASE via OVID (1980 to 23 January 2014) and CINAHL via EBSCO (1980 to 23 January 2014). We searched the US National Institutes of Health Trials Register and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA: Randomised controlled trials of at least four weeks of unsupervised powered toothbrushing versus manual toothbrushing for oral health in children and adults.
DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by The Cochrane Collaboration. Random-effects models were used provided there were four or more studies included in the meta-analysis, otherwise fixed-effect models were used. Data were classed as short term (one to three months) and long term (greater than three months).
MAIN RESULTS: Fifty-six trials met the inclusion criteria; 51 trials involving 4624 participants provided data for meta-analysis. Five trials were at low risk of bias, five at high and 46 at unclear risk of bias.There is moderate quality evidence that powered toothbrushes provide a statistically significant benefit compared with manual toothbrushes with regard to the reduction of plaque in both the short term (standardised mean difference (SMD) -0.50 (95% confidence interval (CI) -0.70 to -0.31); 40 trials, n = 2871) and long term (SMD -0.47 (95% CI -0.82 to -0.11; 14 trials, n = 978). These results correspond to an 11% reduction in plaque for the Quigley Hein index (Turesky) in the short term and 21% reduction long term. Both meta-analyses showed high levels of heterogeneity (I(2) = 83% and 86% respectively) that was not explained by the different powered toothbrush type subgroups.With regard to gingivitis, there is moderate quality evidence that powered toothbrushes again provide a statistically significant benefit when compared with manual toothbrushes both in the short term (SMD -0.43 (95% CI -0.60 to -0.25); 44 trials, n = 3345) and long term (SMD -0.21 (95% CI -0.31 to -0.12); 16 trials, n = 1645). This corresponds to a 6% and 11% reduction in gingivitis for the Löe and Silness index respectively. Both meta-analyses showed high levels of heterogeneity (I(2) = 82% and 51% respectively) that was not explained by the different powered toothbrush type subgroups.The number of trials for each type of powered toothbrush varied: side to side (10 trials), counter oscillation (five trials), rotation oscillation (27 trials), circular (two trials), ultrasonic (seven trials), ionic (four trials) and unknown (five trials). The greatest body of evidence was for rotation oscillation brushes which demonstrated a statistically significant reduction in plaque and gingivitis at both time points.
AUTHORS' CONCLUSIONS: Powered toothbrushes reduce plaque and gingivitis more than manual toothbrushing in the short and long term. The clinical importance of these findings remains unclear. Observation of methodological guidelines and greater standardisation of design would benefit both future trials and meta-analyses.Cost, reliability and side effects were inconsistently reported. Any reported side effects were localised and only temporary.

Matched MeSH terms: Dental Devices, Home Care/adverse effects*; Dental Devices, Home Care/economics*
Fulltext Dental caries and oral health behaviour in the Malaysian Territorial Army Personnel

Borhan Jasmin, Nasruddin Jaafar

Archives of Orofacial Sciences, 2011;6(2):19-25.
MyJurnal

A survey was conducted to assess dental caries experience and oral health related behaviour among Malaysian Territorial Army (TA) personnel. This cross-sectional study involved 284 personnel covering their socio-demography, oral hygiene habits and related behaviour and past utilization of dental services pattern. Dental caries were assessed using DMFT index. Caries prevalence was very high (97.2%; DMFT 8.15±5.36). Untreated decay (DT) was 3.67 (±3.15) and missing teeth (MT) 2.90 (±3.73). However, few were treated teeth (FT) at only 1.58 (±2.02). Almost everyone (98.2%) claimed they brushed their teeth at least once daily and 80% used fluoridated toothpaste. However, very few participants used dental floss (11.3%) while majority (60.2%) did not know about flossing. More than 70% were current smokers. Only 13.7% were regular attendees with the majority (86.3%) visiting the dentist only when they had dental problems. The most common reason (49.7%) for their last dental visit was related to presence of symptoms and few were (27.4%) for prevention. Symptomatic attendees are significantly more likely to have more severe caries experience than preventive oriented individuals (p=0.003). These findings support the importance of promoting preventive oral health utilization behaviour among army personnel.

Matched MeSH terms: Dental Devices, Home Care
Fulltext Use of Oral Cleaning Devices and Their Perceived Benefits among Malaysians in Kuala Lumpur and Johor Bahru: An Exploratory Structured Approach

Mitha S, ElNaem MH, Chandran J, Rajah NP, Fam TY, Babar MG, et al.

J Pharm Bioallied Sci, 2018 12 21;10(4):216-225.
PMID: 30568379 DOI: 10.4103/JPBS.JPBS_296_16

Background and Objectives: Various devices have been used to maintain oral hygiene. These include toothbrush and toothpaste, mouthwash, dental floss, miswak, and toothpick. This study attempts to investigate the use of various oral cleaning devices and their perceived benefits among Malaysians.
Methods: A quantitative cross-sectional study conducted in two different cities of Malaysia. A convenience sampling approach was adopted. A total of 787 participants agreed to participate in the current research. A validated questionnaire translated into national language was used for data collection.
Statistical Analysis Used: Data analysis was performed using Statistical Package for Social Sciences version 20.
Results: About 302 respondents were in the age range of 18 - 25 years old (38.4%). There were marginally more females (55.7%) than males (44.3%). Although 99.9% of the participants used a toothbrush, a significant majority (n = 590, 75%) used more than a single device to maintain their oral hygiene. Only 311 respondents knew that toothpicks were inappropriate to use to remove food between teeth and gums, while a majority (n = 592, 75.2%) did not realize that some mouthwashes can stain the teeth. Less than half (42.1%) knew that improper use of miswak might harm the teeth.
Conclusions: Although their oral hygiene behaviors are relatively at a higher level, their perceived oral health benefits did not compare well.

Matched MeSH terms: Dental Devices, Home Care
Fulltext Dental knowledge and self-reported oral care practices among medical, pharmacy and nursing students

Tuti Ningseh Mohd-Dom, Shahida Mohd Said, Zamirah Zainal Abidin

Jurnal Sains Kesihatan Malaysia, 2009;7(1):13-23.
MyJurnal

A self-administered questionnaire survey was conducted to investigate the level of dental knowledge among senior medical, pharmacy and nursing students of Universiti Kebangsaan Malaysia, and to determine self-reported practices of oral care. Students were invited to complete a set of questionnaires on knowledge related to causes, prevention, signs and treatment of dental caries and periodontal disease; and practices related to oral hygiene and dental visits. A total of 206 questionnaire forms were distributed. 204 forms were returned complete (response rate = 99%). Dental knowledge scores ranged from 0 (no correct answer given) to 16 (gave all correct answers). The mean knowledge scores between the groups were statistically different (p < 0.05): pharmacy students scored highest (mean = 12.29, 95% CI 11.44, 13.14) followed by the medical students (mean = 12.02, 95% CI 11.33, 12.71) and nursing students (mean = 10.83, 95% CI 10.40, 11.26). Areas that had lowest knowledge scores were signs and treatment of gum disease. With regard to oral care practices, majority cited that they brushed teeth at least twice a day (94.6%) and used toothbrush and toothpaste (97.5%). Not many (21.8%) used dental floss and about half (54.2%) reported visiting the dentist more than twelve months ago. Reasons for dental visits included getting check-ups (64.6%), restorations (45.6%) and emergency care such as extractions (24.0%). In general students had at least a moderate level of dental knowledge but demonstrated poor knowledge in some areas. While most reported good oral hygiene habits, behaviour related to dental visits need to be improved. Findings suggest a need for inclusion of oral health education in the medical, pharmacy and nursing curriculum.

Matched MeSH terms: Dental Devices, Home Care
Racial differences in perception of oral health and oral health behaviours in Singapore

Soh G

Int Dent J, 1992 Aug;42(4):234-40.
PMID: 1399041

Knowledge of prevention can influence preventive dental behaviours. This study surveyed knowledge and preventive dental behaviours on the prevention of dental caries and gum disease among the adult population of the three major racial groups in Singapore. Respondents were asked to rate the importance of several preventive measures against dental caries and gum disease. Questions were also fielded on dental behaviours such as preventive visits to the dentist, toothbrushing and flossing. Results showed that there was a general lack of appreciation for the use of flossing, dental sealants and fluoride supplements. Although a majority of respondents thought that regular dental checkups would be essential for prevention, the proportion who actually saw the dentist for preventive care was significantly lower. Respondents provided inappropriate reasons for brushing their teeth. Differences in both preventive knowledge and preventive dental behaviours among racial groups were evident although these were attributed to differences in education and exposure to product information rather than to racial or cultural factors.

Matched MeSH terms: Dental Devices, Home Care
Fulltext Effect of nonsurgical periodontal therapy verses oral hygiene instructions on type 2 diabetes subjects with chronic periodontitis: a randomised clinical trial

Raman RP, Taiyeb-Ali TB, Chan SP, Chinna K, Vaithilingam RD

BMC Oral Health, 2014;14:79.
PMID: 24965218 DOI: 10.1186/1472-6831-14-79

40 subjects with type 2 diabetes and moderate to severe CP were randomly distributed to groups receiving either NSPT or OHI. Periodontal parameters, glycosylated haemoglobin (HbA1c) and high-sensitivity C-reactive protein (hs-CRP) were evaluated at baseline, 2- and 3-months intervals.

Matched MeSH terms: Dental Devices, Home Care