27 July 2023

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Comparing toothbrush technologies on gingivitis, plaque

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Background

Research continues to show an association between oral health and systemic health, further stressing the importance of effective daily plaque removal via toothbrushing to maintain periodontal health and overall well-being. This investigation was undertaken to compare the efficacy of oscillating-rotating, sonic, and manual toothbrushes in reducing gingivitis and plaque in randomized controlled trials (RCTs) with up to 6 months’ follow-up.

Methods

This meta-analysis was conducted from a single database (Procter & Gamble Oral Care Clinical Archive) including RCTs from 2007 to 2022. Three authors independently assessed study eligibility. Disagreements concerning selected studies were resolved by discussion with an expert colleague. Direct and indirect treatment comparisons along with transition rates to gingival health were calculated using participant-level data. Transition-to-health time was calculated using data from all time points. Subregion analyses evaluated number of bleeding sites and plaque reduction.

Results

This meta-analysis included 21 gingivitis RCTs and 25 plaque RCTs. Relative to manual and sonic brushes, oscillating-rotating brushes had a higher percentage of participants who transitioned to gingival health (72% vs 21% and 54%; P < .001). Compared with manual and sonic brushes, respectively, oscillating-rotating brushes demonstrated greater bleeding site reductions (by 52% and 29%; P < .001) and superior plaque reductions (by 19% and 5%; P < .001). Oscillating-rotating brushes provided faster transitions to health than sonic brushes and showed greater efficacy across subregions. The most advanced oscillating-rotating brush demonstrated statistically significantly greater efficacy compared with traditional oscillating-rotating, manual, and sonic brushes when analyzed separately. Risk of bias was deemed low for all studies.

Conclusions

Oscillating-rotating toothbrushes offer superior results for transition to health, gingivitis and plaque reduction compared with manual and sonic brushes. The most advanced oscillating-rotating model offers enhanced efficacy vs traditional models.

Yuanshu Zou, Julie Grender, Ralf Adam, Liran Levin, "A Meta-analysis Comparing Toothbrush Technologies on Gingivitis and Plaque," International Dental Journal, 2023, ISSN 0020-6539, https://doi.org/10.1016/j.identj.2023.06.009.