Efficacy of a New Multi-Head Sonic Toothbrush in Autistic Individuals

Objectives: Toothbrushing is widely recognized as particularly challenging for individuals with Autism Spectrum Disorder (ASD) due to heightened sensitivities. This study aims to assess the tolerance and efficacy of a new multi-head sonic toothbrush in individuals with ASD.
Methods: A convenience sample of individuals diagnosed with ASD (DSM-5) (n=68; 64.7% male; age range 6-55 years) was selected. The Balene Duotech® toothbrush was used, which features six active brushing surfaces, elastomer bristles angled at 45°, and a 180° rotating handle. This design enables simultaneous assisted brushing of both dental arches without the need to remove the device from the mouth. Data collected for each participant included age, sex, levels of social communication, behavioral severity, Brown and Dunn sensory processing profile (sensitive, avoidant, low registration, and seeking), predominant neurosensory profile, educational status (partial/full), and prior use of electric
toothbrushes. The primary outcome variables were tolerance to the toothbrush (rated as poor, good, or excellent) and plaque accumulation, measured using the Plaque Index (PI) by Löe and Silness, and the Simplified Oral Hygiene Index (OHIS) by Greene and Vermillion. Participants who rejected the toothbrush during the initial session were provided with up to five desensitization sessions, after which they were re-evaluated.
Results: 73.5% of participants tolerated the brushing during the first session. Tolerance was significantly associated with the avoidant sensory profile (p<0.01). The reduction in OHI-S scores before versus after brushing was statistically significant across anterior, posterior, and overall evaluated teeth (p<0.001). The effectiveness in plaque removal was significantly influenced by the sensitive sensory profile (p<0.001).
Conclusions: The Balene Duotech® toothbrush is well-accepted by individuals with ASD, regardless of age or the severity of their condition. Its effectiveness in plaque removal positions it as a valuable tool for enhancing oral health in this population.