Toothbrushing–Should We Advise Mechanical or Power Brushes? Results of an International Delphi Conference
Crawford Bain, Arwa Al Sayed, Eleftherios G Kaklamanos, Hizbullah AA Kazi
Delphi consensus conference, Manual brushes, Power brushes, Toothbrushing
Citation Information :
Bain C, Sayed AA, Kaklamanos EG, Kazi HA. Toothbrushing–Should We Advise Mechanical or Power Brushes? Results of an International Delphi Conference. J Contemp Dent Pract 2018; 19 (10):1169-1173.
Background and aim: To develop evidence-based answers to a series of questions in relation to toothbrushing using a modified Delphi consensus approach.
Oral hygiene and especially toothbrushing have been a fundamental part of the efforts to prevent caries and gingivitis. The questions discussed involved the frequency and duration of brushing, the effectiveness and safety of powered brushes and the recommendations for children and orthodontic patients.
Review results: The Delphi panel agreed that twice daily brushing for 2 minutes and a systematic pattern is advised. Moreover, it was concluded that evidence suggests that power brushes are safe and more effective in the short and long-term compared to manual brushes in terms of plaque removal and gingivitis reduction. For children and orthodontic patients, the likelihood of enhancing compliance/convenience with use of a power brush was highlighted.
Conclusion: Toothbrushing constitutes a fundamental part of the efforts to prevent caries and gingivitis.
Clinical significance: Twice daily brushing for 2 minutes and a systematic pattern is advised. Power brushes are safe and could provide benefits, for adults, children and orthodontic patients.
Linden GJ, Lyons A, Scannapieco FA. Periodontal systemic associations: review of the evidence. J Periodontol 2013;84(4 Suppl):S8-S19.
Berchier CE, Slot DE, Haps S, Van der Weijden GA. The efficacy of dental floss in addition to a toothbrush on plaque and parameters of gingival inflammation: a systematic review. Int J Dent Hyg 2008;6:304-314.
Hujoel PP, Cunha-Cruz J, Banting DW, Loesche WJ. Dental flossing and interproximal caries: a systematic review. J Dent Res 2006;85:298-305.
Sambunjak D, Nickerson JW, Poklepovic T, Johnson TM, Imai P, Tugwell P, Worthington HV. Flossing for the management of periodontal diseases and dental caries in adults. Cochrane Database Syst Rev 2001:CD008829.
Balasubramanian R, Agarwal D. Delphi Technique; A review. Int J Public Health Dent. 2012;3:16-25.
Kressin NR, Boehmer U, Nunn ME, Spiro A 3rd. Increased preventive practices lead to greater tooth retention. J Dent Res 2003;82:223-227.
Bosman CW, Powell RN. The reversal of localized experimental gingivitis. A comparison between mechanical toothbrushing procedures and a 0.2% chlorhexidine mouthrinse. J Clin Periodontol 1977;4:161-172.
Lang NP, Cumming BR, Löe H. Toothbrushing frequency as it relates to plaque development and gingival health. J Periodontol 1973;44:396-405.
Davies RM, Davies GM, Ellwood RP. Prevention. Part 4: Toothbrushing: what advice should be given to patients? Br Dent J 2003;195:135-141.
Yaacob M, Worthington HV, Deacon SA, Deery C, Walmsley A, Robinson PG, Glenny A. Powered versus manual toothbrushing for oral health. Cochrane Database Syst Rev 2014:CD002281.
Gibson S, Williams S. Dental caries in pre–school children: associations with social class, toothbrushing habit and consumption of sugars and sugar–containing foods further analysis of data from the National Diet and Nutrition Survey of Children Aged 1.5–4.5 Years. Caries Res 1999;33:101–113.
Kaklamanos EG, Kalfas S. Meta-analysis on the effectiveness of powered toothbrushes for orthodontic patients. Am J Orthod Dentofac Orthop 2008;133:187.e1–187.e14.
Clerehugh V, Williams P, Shaw WC, Worthington HV, Warren P. A practice-based randomized controlled trial of the efficacy of an electric and a manual toothbrush on gingival health in patients with fixed orthodontic appliances. J Dent 1998;26:633-639.
Renvert S, Roos-Jansåker A-M, Claffey N. Non-surgical treatment of peri-implant mucositis and peri-implantitis: a literature review. J Clin Periodontol 1998;35:305–315.
Niemi M-L, Ainamo J, Etemadzadeh H. Gingival abrasion and plaque removal with manual versus electric toothbrushing. J Clin Periodontol 1986;13:709–713.
Rajapakse PS, McCracken GI, Gwynnett E, Steen ND, Guentsch A, Heasman P. Does tooth brushing influence the development and progression of non-inflammatory gingival recession? A systematic review. J Clin Periodontol 2007;34:1046–1061.
Matthews DC. Prevention and treatment of periodontal diseases in primary care. Evid Based Dent 2014;15: 68–69.