Manual Versus Powered Toothbrushing in Patients with Intellectual Disability

Objectives: To compare the supervised and unsupervised use of powered or manual toothbrush in patients with intellectual disability (ID) in terms of plaque and gingival indices and adverse effects.
Methods: Subjects with ID were recruited for this randomised, single-blinded (examiner), 6-month clinical trial. Primary outcome variables were plaque (PlI) and gingival (GI) indices, evaluated at baseline and 3 months after supervised manual or powered tooth brushing and then after 3 additional months of unsupervised used. Student t test, Mann-Whitney and Sign Rank tests, ANCOVA and Chi square test were used to evaluate statistically significant differences.
Results: 64 patients (34 male, mean age 34.5, ranging 21-51) were included in the study. Two categories of ID were included, light (n=54) and limit (n=10). Statistically significant reductions (p<0.05) were observed for PlI and GI in both study groups after 3 and 6 months, with no differences between groups. Lower calculus levels were observed in the powered toothbrush group at the 3-month visit (p=0.044). No relevant adverse effect or technical problems were observed.
Conclusions: The use of powered or manual toothbrushes significantly improves plaque and gingivitis levels, in patients with mild to limit ID. The tested powered toothbrush was as effective and safe as the manual toothbrush, and showed some additional significant benefits in terms of calculus.