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ELECTRIC TOOTHBRUSHING DELIVERS LONG TERM ORAL HEALTH BENEFITS

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INTRODUCTION

Electric toothbrushes are the smart choice for better oral health. An 11-year study shows that electric brushing has a significant long-term effect on tooth loss, plaque removal and gingival issues. This article highlights key research findings to support the superior oral health benefit achieved using electric toothbrushing.

NEW EVIDENCE CONFIRMS LONG-TERM BENEFITS OF ELECTRIC TOOTHBRUSH USE

A recently published study has shown long-term use of an electric toothbrush slows progression of periodontal problems and helps prevent tooth loss. The 11-year cohort study demonstrated that electric toothbrush users benefited from 20% less tooth loss than manual toothbrush users (1).

Effective biofilm removal by toothbrushing is a fundamental action in preventing the progression of oral issues. Biofilm accumulation is the predominant driver of gingivitis, periodontitis and caries, the known principal causes of tooth loss.

Powered toothbrushes have been shown to have produced superior oral health benefits compared to manual toothbrushing (3). Using an evidence-based approach, clinicians can feel confident in recommending powered toothbrushing for a more efficient biofilm removal compared to manual toothbrushing2.

POWERED TOOTHBRUSHES SHOW SIGNIFICANTLY BETTER PLAQUE REMOVAL AND REDUCED GINGIVITIS

A 2014 Cochrane systematic review considered 51 trials involving 4,624 participants. The findings of the review demonstrated that significant oral health benefits were achieved using a powered toothbrush compared to a manual toothbrush.

Statistically, plaque removal was significant in the powered toothbrush group, which showed an 11% plaque reduction at one to three months, and a 21% plaque reduction following three months’ usage. Reduction of gingivitis was recorded as a 6% reduction in the short term (one to three months) and an 11% reduction after long-term use (3).

OSCILLATING ROTATING POWERED TOOTHBRUSHES SHOW GREATER PLAQUE AND GINGIVITIS REDUCTION

Clinical studies have shown oscillating rotating electric toothbrushes provide statistically significantly greater plaque reductions and improvements in gum health versus manual toothbrushes and several other electric toothbrushes. (4-13)
Notably the 2014 Cochrane review showed Oscillating-Rotating (O-R) electric toothbrushes reduce plaque, demonstrably improving oral, and especially gum, health both in the short and in the long term, compared to manual toothbrushes (3). As the market leader in this category, Oral-B can link the positive results to its proven Oscillating-Rotating technology.

A newly published meta-analysis of the effects of oscillating-rotating electric toothbrushes on plaque and gingival health continues to support the superior efficacy of O-R technology. This analysis included studies conducted between 2007-2017 and involved OR toothbrushes manufactured by Procter & Gamble. Key findings showed that those subjects that used an OR brush had 7.4 x greater odds of transitioning to a healthy state vs manual users and 1.8 x greater odds of transitioning to a healthy state vs sonic users(15). Oscillating-rotating electric toothbrushes were also shown to be more effective in plaque removal when compared to manual and sonic brushing – O-R users had 20% and 4% more plaque removal respectively (14).

O-R O-R vs Manual O-R vs Sonic Sonic vs Manual
Bleeding sites 50.3% 28% 34%
Transitioning to generally healthy (<10% bleeding sites) 7.4x 1.8x
Plaque reduction 20% 4% 12%
ELECTRIC TOOTHBRUSHES HELP PREVENT TOOTH LOSS

The 2014 Cochrane review expressed a need for trials of a longer duration to further evaluate the effects of powered toothbrushes. The 11-year cohort study has fulfilled this criterion, giving insight into the long-term effects of electric toothbrush usage. the Study of Health in Pomerania (SHIP), used data of 2,819 subjects from to provide important insights about the oral health benefits associated with electric toothbrush usage.

Overall, the study demonstrated that long term use of electric toothbrushes delivered significant oral health benefits. When compared to manual toothbrush usage results shown were improved periodontal health; Electric toothbrush users when compared to manual toothbrush users showed significantly lower progression for mean probing depth (22.0%), clinical attachment loss (21.0%), and decayed/missing/filled surfaces (17.7%) (Table 1). Electric toothbrush users also retained 19.5% more teeth compared to manual toothbrush users (Table 1).

Table 1: Rate of change over 11 years for electric and manual toothbrush users (after adjusting for cofounders)
Characteristic (mean) Manual Brush Rate of Change Electric Brush Rate of Change % difference (electric v manual)
Probing Depth 0.41 0.32 -22.0%
Clinical Attachment Loss 0.93 0.74 -21.0%
Decayed/Missing/Filled Surfaces 7.43 6.11 -17.7%
Number of teeth present 1.86 1.50 -19.5%

Besides proving health benefits of power toothbrushes, the rising popularity and thus the use is also indicated in the study: At the start of the 11-year long study, 18% of the participants used an electric toothbrush. At the end, the figure had risen to 37%(1).

CONCLUSION

Collectively, the 11-year data, in conjunction with other published findings, strongly support use of electric toothbrushes for long-term maintenance of oral health, along with further evidence to support the recommendation, in particular, of Oscillating-Rotating (O-R) electric toothbrushes for clinicians’ patients.

Learn more about Oral B Electric Toothbrushes

REFERENCES
1 Pitchika V et al Long-term impact of powered toothbrush on oral health: 11-year cohort study J Clin Periodontol, 2019
2 Zenkner_JE et al Influence of eruption stage and biofilm accumulation on occlusal caries in permanent molars: a generalized estimating equations logistic approach. Caries Research 2013;47(3):177-82
3 Yaacob M et al, Powered versus manual toothbrush for oral health. (Review) Cochrane Database Syst Rev 2014;(6):CD002281
4 Ccahuana-Vasquez R, et al. An 8-Week Clinical Comparison of an Oscillating-Rotating Electric Rechargeable Toothbrush and a Sonic Toothbrush in the Reduction of Gingivitis and Plaque J Clin Dent 2018;29:27–32.
5 Ccahuana-Vasquez R et al. An Eight-Week Clinical Evaluation of an Oscillating-Rotating Power Toothbrush with a Brush Head Utilizing Angled Bristles Compared with a Sonic Toothbrush in the Reduction of Gingivitis and Plaque J Clin Dent 2015;26:80-85
6 Klukowska M, et al. A randomized 12-week clinical comparison of an oscillating-rotating toothbrush to a new sonic brush in the reduction of gingivitis and plaque J Clin Dent 2014;25:26-31.
7 Klukowska M, et al. A six-week clinical evaluation of the plaque and gingivitis efficacy of an oscillating-rotating power toothbrush with a novel brush head utilizing angled CrissCross bristles versus a sonic toothbrush J Clin Dent 2014;25:6-12.
8 Grender J, et al. Plaque removal efficacy of oscillating-rotating power toothbrushes: review of six comparative clinical trials Am J Dent 2013; 26(2):68-74.
9 Klukowska M, et al. A randomized clinical trial evaluating gingivitis and plaque reduction of an oscillating-rotating power brush with a new brush head with angled bristles versus a marketed sonic brush with self-adjusting technology Am J Dent 2014;27:179-184.
10 Klukowska M, et al. A 12-week clinical comparison of an oscillating-rotating power brush versus a marketed sonic brush with self-adjusting technology in reducing plaque and gingivitis J Clin Dent 2013;24:55–61.
11 Klukowska M, et al. 12-week clinical evaluation of a rotation/oscillation power toothbrush versus a new sonic power toothbrush in reducing gingivitis and plaque Am J Dent 2012;25:287-292
12 Williams KB, et al. Comparison of rotation/oscillation and sonic power toothbrushes on plaque and gingivitis for 10 weeks Am J Dent 2009;22:345-349
13 Goyal CR, et al. A randomized 12-week study to compare the gingivitis and plaque reduction benefits of a rotation-oscillation power toothbrush and a sonic power toothbrush J Clin Dent 2009; 20:93-98.
14 Grender JG et al The effects of oscillating-rotating electric toothbrushes on plaque and gingival health: A meta-analysis Am J Dent 2020; 33:3-11
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