Plaque removal with the uninstructed use of electric toothbrushes: comparison with a manual brush and toothpaste slurry

Background: Individuals purchasing electric toothbrushes for the Ist time w ill mostly only have the manufacturer's instructional leaflet for informati on of usage. Aims: This study was designed to simulate the ist-time purchase and early u se of an electric toothbrush with the aim of comparing plaque removal with a manual toothbrush. Secondary aims were to assess chemical plaque removal effects of a toothpaste slurry and to compare between 2 electric brushes wh ich differed only in head speed. Methods: A group of 16 dentate subjects participated in this single-examine r blind, randomised, crossover design balanced for residual effects. Subjec ts had "average" oral hygiene and had never used an electric toothbrush pre viously. 7 days prior to the study, all subjects received the slower oscill ating rotating toothbrush under test to use at home as they wished. The tes t treatments were brushing with 2 oscillating rotating electric toothbrushe s, a manual toothbrush and a rinse with a toothpaste slurry (3 g/10 mi wate r). On day 1 of each study period, subjects were rendered plaque-free, susp ended oral hygiene and returned on day 5. Plaque was scored at baseline by index and area and after 30 s, 30 s (total 60 s) and 60 s (total 120 s) of the cleaning treatments. Washout periods were at least 2 1/2 days. Results: Highly significant treatment differences were found between the 4 treatments because the toothpaste slurry was totally without effect. Analys es between the 3 brush treatments overall revealed no consistent significan t differences. The data suggest that in the early days of electric toothbru sh use, subjects perform no better than using a manual brush. Conclusions: The present study taken with results from others showing great er benefits from the use of electric brushes, supports the idea that dental professionals should, where possible, provide advice and instruction in th e use of such devices.