A practice-based randomised controlled trial of the efficacy of an electric and a manual toothbrush on gingival health in patients with fixed orthodontic appliances

Objectives. The aim of the present study was to evaluate the efficacy of an electric toothbrush with a specially designed orthodontic brush head compared with a manual toothbrush in controlling plaque and gingivitis in patients with fixed orthodontic appliances over an 8-week period in a dental practice setting.

Methods. This was a randomised controlled, single blind, stratified, parallel group trial conducted in two specialist orthodontic dental practices by a specialist orthodontist. Group 1 comprised 41 subjects who used the electric toothbrush and Group 2 consisted of 43 subjects who brushed with a manual toothbrush around the orthodontic appliance for a timed 2 minutes twice daily for 8 weeks.

Plaque around the fixed appliance attachments was measured using an orthodontic modification to the Silness and Loe plaque index, while gingival condition was scored using the gingival index and Eastman interdental bleeding index.

Results. There was baseline balance for all clinical variables (p>0.05). Both groups had significantly less plaque after 8 weeks than at baseline (p<0.001) but the group using the electric brush also had significantly less interdental gingival bleeding, as determined by the Eastman interdental bleeding index both at week 4 (p<0.001) and week 8 (p=0.004). The majority of subjects (n=54, 64.3%) preferred the electric toothbrush.

Conclusions. In conclusion, the results from this study would suggest that use of an electric toothbrush with an orthodontic brush head may be of benefit in promoting gingival health in fixed orthodontic appliance patients; however, the long-term effects (over at least 6 months) need to be evaluated.