18 August 2023

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A 3D-printed plaque removal mouthguard for older adults

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Introduction

Older adults are at great risk for dental caries and periodontal diseases due to the accumulation of dental plaque in the oral cavity. The high prevalence of xerostomia amongst older adults could increase the rate of microbial colonization, while decreasing hand function due to age, trauma or disease makes it more difficult to clean the teeth thoroughly. 

Hong Kong is an aging society, with more than 21% of its citizens expected to be older than 65 years by 2024. However, due to staff shortages and inadequate funding, both institutional and home care services struggle to provide sufficient oral care for older adults who have difficulties with self-care.

Consequently, the oral health status of older adults, particularly those in long-term care, is far from satisfactory. A 2011 oral health survey revealed that more than 50% of institutionalized older adults had untreated dental caries, with an average of 2.2 to 3 decayed teeth per person.

Furthermore, almost all institutionalized older adults had periodontal problems, such as gum bleeding and attachment loss of more than 4 mm.

Objectives

The aim of the study was to examine the plaque removal effectiveness of a personalized 3D-printed dental plaque removal mouthguard device in a clinical trial setting.

Methods

A personalized 3D-printed mouthguard was developed to clean dental plaque using micro-mist. A clinical trial was conducted to examine the plaque removal effectiveness of this device. The clinical trial recruited 55 participants (21 males and 34 females) with an average age of 68.4 years (range, 60–81 years). Dental plaque was dyed by plaque disclosing liquid (Ci).

Researchres used the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI) to evaluate the level and rate of plaque formation on the tooth surface.

The TMQHPI was recorded, and intraoral photos were taken before and after mouthguard cleaning.

The plaque removal rate was calculated based on TMQHPI and intraoral photos (pixel-based method) before and after cleaning.

Results

The personalized 3D-printed micro-mist injection mouthguard can be effective in dental plaque removal on tooth and gingiva, and the effectiveness lies between that of a manual toothbrush and a mouth rinse. The newly proposed pixel-based method can be a practical, highly sensitive tool to evaluate the level of plaque formation.

Conclusions

Under the conditions of the present study, we conclude that the personalized 3D-printed micro-mist injection mouthguard can be useful in reducing dental plaque and may be especially suitable for older adults and disabled people.

Hao Ding, Meng Zhang, Brian Lo, Karfield K.F. Chan, Edward C.M. Lo, James K.H. Tsoi, "A Personalised 3D-Printed Dental Plaque Removal Mouthguard for Older Adults," International Dental Journal, 2023, ISSN 0020-6539, https://doi.org/10.1016/j.identj.2023.04.005.