Objective: Individuals with cerebral palsy (CP) are at risk for aspirating during tooth brushing, due to weakness or paralysis of jaw muscles, palate, pharynx, vocal cords, and tongue, they are also at increased risk for periodontal disease. Objective is to evaluate a power toothbrush for increased risk of aspiration and improving oral health. Methods: Data collected: plaque index (PI), bleeding index (BI), and periodontal screening and recording (PSR) from a convenience sample of 11 patients (8 female, median age 16 yrs, 9 white). The study design was a pre-test post-test without a control : Group A used power and Group B brushed using manual during fiberoptic endoscopy (FEES). Those not aspirating used a power brush daily for an additional 2 months, while those who did aspirate used a manual brush. Split-plot ANOVAs were used to compare gingival health before and after intervention in each treatment group. Results: At baseline, 5 individuals aspirated when their teeth were cleaned with the power but not with the manual toothbrush, 1 aspirated with the manual but not the power brush, and the other 5 did not aspirate with either brush. Follow-up comparisons were made between the 5 using the manual and the 6 using the powered toothbrush. PI decreased more for those using the power brush (X, SD) = 70.8 (23.2) vs. 40.5 (15.1)) than for those using the manual brush (X, SD) = 71.0 vs. 53.6 (23.5)), p< .05). Bleeding was reduced to a similar extent following treatment with either brush (X, SD)= 46.9 (27.9) before vs. 34.6 (27.3), p<.05). after treatment), as was PSR, where (X, SD) = 2.1 (1.0) before vs. 1.7 (0.6),p<.05 after treatment. Conclusion: Aspiration was seen in about half using power brushing. The power toothbrush, however showed better oral hygiene than manual brushing in this population.