The Efficacy of a Sonic Electric Toothbrush in Periodontal Patients

Objective: The purpose of this study was to evaluate the superior efficacy of a sonic electric toothbrush (Sonicare® Elite® Pro) over a manual toothbrush (Oral B® 35) on supragingival plaque removal with periodontal maintenance patients who exhibit insufficient oral hygiene practices. Methods: Forty-two periodontal maintenance patients were selected for randomised, single blind, crossover clinical study. Thirty-seven completed the study. A toothpaste (Dentagard®) was provided and mouth rinse was not permitted. The patients continued their usual approximal cleaning procedures. The study design consisted of two 12-week trial periods with a two-week wash-out period. At baseline-1 patients received a professional tooth cleaning, following which they were randomly selected for either a manual or electric toothbrush and received instructions. Full-mouth plaque scores (Silness & Loe, 1973; six surfaces per tooth) were taken after eight and twelve weeks. Subsequently patients were instructed to return to their pre-study brushing practices for two weeks. At baseline-2 both groups received another professional tooth cleaning and the toothbrush types were switched. Again full-mouth plaque scores were taken after eight and twelve weeks. Data were summarized by mean and standard deviation. Treatment effects were evaluated with parametric (Welch modified t-test) as well as non-parametric methods (Wilcoxon rank sum test). Results: A mean difference of 0.74 (95% confidence interval 0.52-0.96, p<0.001) in favour of the sonic electric toothbrush was found for the full mouth plaque score after 8 weeks of treatment. A similar result was found after 12 weeks of treatment (0.76; 0.50-1.03, p<0.001). Statistical tests were based on first-period results only due to the presence of differential carry-over. Conclusion: A sonic electric toothbrush is more effective in plaque reduction than a manual toothbrush in periodontal patients who practice inadequate oral healthcare. This study received no outside funding beyond the provision of sonic electric toothbrushes by Philips Oral Healthcare.