Different powered toothbrushes for plaque control and gingival health

Background: Powered brushes were first introduced commercially in the 1960s. A recent systematic review suggested the superiority of certain modes of powered over manual toothbrushing for plaque and gingivitis reduction. That review did not allow for direct comparison between different modes of powered toothbrush. Objectives: To compare different modes of powered toothbrushing against each other for plaque reduction and the health of the gingivae. Other factors to be assessed were calculus and stain removal, cost, dependability and adverse effects. Search strategy: The following databases were searched: Cochrane Oral Health Group’s Trials Register (to 26 July 2010); Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 3); MEDLINE via OVID (1950 to 26 July 2010); EMBASE via OVID (1980 to 26 July 2010); CINAHL via EBSCO (1982 to 26 July 2010). There were no language restrictions. Selection criteria: Trials were considered for inclusion with the following criteria: random allocation of participants; no compromised manual dexterity; unsupervised powered toothbrushing for at least four weeks. The primary outcomes were the plaque and gingivitis scores after powered toothbrush use during trial period. Data collection and analysis: Data extraction was performed independently and in duplicate. The authors of trials were contacted to provide missing data where possible. The effect measure for each meta-analysis was the standardized mean difference (SMD) with 95% confidence intervals (CI) using the random-effects model. Potential sources of heterogeneity were assessed. Main results: The review included data from 15 trials with 1015 participants. Due to the dearth of trials assessing the same mode of action, no definitive conclusions can be stated regarding the superiority of one mode of powered toothbrush over any other. Only minor and transient side effects were reported. Cost, dependability were not reported. Authors’ conclusions: Further trials of good quality are required to establish if any mode of action has superiority over the other modes of action for powered toothbrushes. PLAIN LANGUAGE SUMMARY Different types of powered toothbrushes for plaque control and healthy gums Powered brushes were first introduced commercially in the 1960s. A previously published Cochrane systematic review suggested one type of powered brush was superior to manual toothbrushing for the removal of plaque and reduction of gum inflammation. That review did not allow direct comparison between the different types of powered toothbrushes. This review included data from 15 trials with 1015 participants. Due to the low numbers of trials using different types of powered brushes, no definitive conclusions can be drawn regarding the superiority of any one type of powered toothbrush over another. Only minor and transient side effects were reported. Cost and reliability of the brushes were not reported in the trials. Further trials of good quality are required to establish if any type of powered brush has superiority over the other types of action for powered toothbrushes.