Duration of toothbrushing with fixed appliances: a randomized crossover clinical trial. 2022

Vasiliki Koretsi, and Rebecca Klinke, and Philip Herreiner, and Peter Proff, and Christian Kirschneck
Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland.

Fixed orthodontic appliances might result in dental adverse effects, if sufficient oral hygiene is not maintained. Since recommendations on toothbrushing times are lacking scientific justification in orthodontic populations, the aim of the present study was to comparatively quantify the duration of toothbrushing with a manual and a powered toothbrush in two distinct age groups. Two-centre, two-period crossover balanced randomized clinical trial with computer-generated numbers and blinding at the outcome-assessing level. Children and adults with fixed appliances with at least 22 aligned teeth were recruited at a university clinic and private practice in Bavaria, Germany. Plaque was disclosed with staining tablets and participants brushed their teeth with their habitual technique in front of a mirror and without interference until staining was, to their own satisfaction, completely removed. The primary outcome was duration of toothbrushing in seconds. Secondary outcomes were percentage plaque reduction and questionnaire data on dental attitudes and behaviours. Data were analysed with linear mixed models. Twenty-eight participants were randomized to the first and 27 to the second toothbrush sequence. The combined effect of age and toothbrush on the duration of toothbrushing was evident (n = 52, F(1, 50.8) = 5.1, P = 0.028). Children brushed 14.5 seconds less [n = 28, 95% confidence interval (CI) = -31.3 to 2.3, P = 0.090], yet adults 13.3 seconds more (n = 24, 95% CI = -4.6 to 31.3, P = 0.143) with the manual than powered toothbrush. Brushing times ranged from 2 minutes and 45 seconds to 3 minutes and 17 seconds with plaque reduction at 76% and good dental attitudes and behaviours. Both children and adults with fixed appliances might equally reach an effective plaque reduction with either manual or powered toothbrushes and their habitual brushing technique in around three minutes, if plaque is visible. DRKS-German Clinical Trials Register ID: DRKS00012463. Oral-B Procter & Gamble.

UI MeSH Term Description Entries
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003773 Dental Plaque A film that attaches to teeth, often causing DENTAL CARIES and GINGIVITIS. It is composed of MUCINS, secreted from salivary glands, and microorganisms. Plaque, Dental
D003774 Dental Plaque Index An index which scores the degree of dental plaque accumulation. Dental Plaque Indexes,Dental Plaque Indices,Index, Dental Plaque,Indexes, Dental Plaque,Indices, Dental Plaque
D004867 Equipment Design Methods and patterns of fabricating machines and related hardware. Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077744 Orthodontic Appliances, Fixed ORTHODONTIC APPLIANCES attached to the teeth by adhesive material which cannot be removed from the mouth by the patient. These devices apply force to the teeth and supporting structures, thereby producing changes which control their growth and development. Bonded Retainer,Fixed Appliances,Fixed Functional Appliances,Fixed Retainer,Permanent Retainer,Appliance, Fixed,Appliance, Fixed Functional,Appliance, Fixed Orthodontic,Appliances, Fixed,Appliances, Fixed Functional,Appliances, Fixed Orthodontic,Bonded Retainers,Fixed Appliance,Fixed Functional Appliance,Fixed Orthodontic Appliance,Fixed Orthodontic Appliances,Fixed Retainers,Functional Appliance, Fixed,Functional Appliances, Fixed,Orthodontic Appliance, Fixed,Permanent Retainers,Retainer, Bonded,Retainer, Fixed,Retainer, Permanent,Retainers, Bonded,Retainers, Fixed,Retainers, Permanent
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D014099 Toothbrushing The act of cleaning teeth with a brush to remove plaque and prevent tooth decay. (From Webster, 3d ed) Toothbrushings
D016037 Single-Blind Method A method in which either the observer(s) or the subject(s) is kept ignorant of the group to which the subjects are assigned. Single-Masked Study,Single-Blind Study,Single-Masked Method,Method, Single-Blind,Method, Single-Masked,Methods, Single-Blind,Methods, Single-Masked,Single Blind Method,Single Blind Study,Single Masked Method,Single Masked Study,Single-Blind Methods,Single-Blind Studies,Single-Masked Methods,Single-Masked Studies,Studies, Single-Blind,Studies, Single-Masked,Study, Single-Blind,Study, Single-Masked

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