Disclosure Statement, Introduction | Waterpik Technologies DT400

Disclosure Statement

•This course was designed, developed and produced by Waterpik Technologies

•Waterpik Technologies manufactures and distributes products addressed in this course

Course Objective

To provide the dental team with the information and criteria needed to assist individuals in selecting a power toothbrush appropriate to need

Learning Outcomes

•Discuss the clinical evidence from power toothbrush research

•Identify which individuals will benefit from a power toothbrush

•Recommend a power toothbrush appropriate to need

Introduction

Power brushes have been in existence for many years. In the past, recommendations were often reserved for those individuals with special needs. Today, with the wide vari- ety of products on the market, almost any individual can benefit from a power brush.1

A practice-based study that included 3,669 dental profes- sionals and 16,903 subjects demonstrates how typical den- tal office patients can benefit from a power brush. In the study, power toothbrush use was considered by dental pro- fessionals to have a positive effect on the oral health of 80.5% of patients. Patients agreed, with 74% stating that they thought the power brush resulted in better oral hygiene. Ninety four percent (94%) of patients reported that they would continue to use their power brush and 75% said they would recommend it to a friend.2

Power brushes are good choices for many individuals. They may be ideal devices for people who provide care to the homebound or for those institutionalized or living in a nursing home. In working with individuals, consider those who present with any of the following as prime candidates for using a power brush:3,4

•Poor plaque (biofilm) control

•Gingivitis

•Periodontal maintenance

•Orthodontic appliances

•Implants

•Aesthetic restorations

•Crowns and bridges

•Physically challenged

•Gingival overgrowth

The Best Power Brush

A January 2003 systematic review5 of power brushes by the Cochrane Collaboration evaluated different types of power brushes and tried to determine the superiority of one type of brush over another. The reviewers evaluated 354 clinical trials published between 1964 and 2001. The 354 studies were reviewed for the following criteria:5

•Study design had to be a randomized, controlled trial comparing manual and power toothbrushes

•Comparisons between power brushes were excluded

•Crossover trials were eligible but not split mouth designs

•Subjects could not have a disability that would affect toothbrushing; orthodontic appliances were allowed

•Brushing had to be unsupervised

•Combined interventions such as those with rinsing or irrigating were excluded

•Study had to be a minimum of 28 days

•Outcomes measures had to include biofilm (plaque) and gingivitis

From these standards, 29 studies fulfilled all inclusion cri- teria and had results that could be used for meta-analysis. The total number of subjects in these trials was 2,547. Of those, 239 or 9.4% were lost to follow-up.5

The 29 trials were further categorized into groups based on the mechanism of action. Six groups resulted. These included:5

•Side-to-side action with 8 studies

•Counter oscillation with 5 studies

•Rotation oscillation with 11 studies

•Circular with 3 studies

•Ultrasonic with 2 studies

•Unknown action with 0 studies