Powered versus manual toothbrushing for oral health (Review)

Background Removing dental plaque may play a key role maintaining oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this. This is an update of a Cochrane review first published in 2003, and previously updated in 2005. Objectives To...

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Main Authors:	Yaacob, Munirah, Worthington, Helen V., Deacon, Scott A., Deery, Chris, Walmsley, Damien A., Robinson, Peter G., Glenny, Anne-Marie
Format:	Article
Language:	English English
Published:	Wiley-Blackwell 2014
Subjects:	RK Dentistry
Online Access:	http://irep.iium.edu.my/37370/ http://irep.iium.edu.my/37370/ http://irep.iium.edu.my/37370/ http://irep.iium.edu.my/37370/4/37370_Powered%20versus%20manual%20toothbrushing%20for%20oral%20health_WOS.pdf http://irep.iium.edu.my/37370/10/37370_Powered%20versus%20manual%20toothbrushing%20for%20oral%20health.pdf

id	iium-37370
recordtype	eprints
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English
topic	RK Dentistry
spellingShingle	RK Dentistry Yaacob, Munirah Worthington, Helen V. Deacon, Scott A. Deery, Chris Walmsley, Damien A. Robinson, Peter G. Glenny, Anne-Marie Powered versus manual toothbrushing for oral health (Review)
description	Background Removing dental plaque may play a key role maintaining oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this. This is an update of a Cochrane review first published in 2003, and previously updated in 2005. Objectives To compare manual and powered toothbrushes in everyday use, by people of any age, in relation to the removal of plaque, the health of the gingivae, staining and calculus, dependability, adverse effects and cost. Search methods We searched the following electronic databases: the Cochrane Oral Health Group’s Trials Register (to 23 January 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 1), MEDLINE via OVID (1946 to 23 January 2014), EMBASE via OVID (1980 to 23 January 2014) and CINAHL via EBSCO (1980 to 23 January 2014). We searched the US National Institutes of Health Trials Register and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. Selection criteria Randomised controlled trials of at least four weeks of unsupervised powered toothbrushing versus manual toothbrushing for oral health in children and adults. Data collection and analysis We used standard methodological procedures expected by The Cochrane Collaboration. Random-effects models were used provided there were four or more studies included in the meta-analysis, otherwise fixed-effect models were used. Data were classed as short term (one to three months) and long term (greater than three months). Powered versus manual toothbrushing for oral health (Review) 1 Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Main results Fifty-six trials met the inclusion criteria; 51 trials involving 4624 participants provided data for meta-analysis. Five trials were at low risk of bias, five at high and 46 at unclear risk of bias. There is moderate quality evidence that powered toothbrushes provide a statistically significant benefit compared with manual tooth- brushes with regard to the reduction of plaque in both the short term (standardised mean difference (SMD) -0.50 (95% confidence interval (CI) -0.70 to -0.31); 40 trials, n = 2871) and long term (SMD -0.47 (95% CI -0.82 to -0.11; 14 trials, n = 978). These results correspond to an 11% reduction in plaque for the Quigley Hein index (Turesky) in the short term and 21% reduction long term. Both meta-analyses showed high levels of heterogeneity (I2 = 83% and 86% respectively) that was not explained by the different powered toothbrush type subgroups. With regard to gingivitis, there is moderate quality evidence that powered toothbrushes again provide a statistically significant benefit when compared with manual toothbrushes both in the short term (SMD -0.43 (95% CI -0.60 to -0.25); 44 trials, n = 3345) and long term (SMD -0.21 (95% CI -0.31 to -0.12); 16 trials, n = 1645). This corresponds to a 6% and 11% reduction in gingivitis for the Löe and Silness index respectively. Both meta-analyses showed high levels of heterogeneity (I2 = 82% and 51% respectively) that was not explained by the different powered toothbrush type subgroups. The number of trials for each type of powered toothbrush varied: side to side (10 trials), counter oscillation (five trials), rotation oscillation (27 trials), circular (two trials), ultrasonic (seven trials), ionic (four trials) and unknown (five trials). The greatest body of evidence was for rotation oscillation brushes which demonstrated a statistically significant reduction in plaque and gingivitis at both time points. Authors’ conclusions Powered toothbrushes reduce plaque and gingivitis more than manual toothbrushing in the short and long term. The clinical importance of these findings remains unclear. Observation of methodological guidelines and greater standardisation of design would benefit both future trials and meta-analyses.
format	Article
author	Yaacob, Munirah Worthington, Helen V. Deacon, Scott A. Deery, Chris Walmsley, Damien A. Robinson, Peter G. Glenny, Anne-Marie
author_facet	Yaacob, Munirah Worthington, Helen V. Deacon, Scott A. Deery, Chris Walmsley, Damien A. Robinson, Peter G. Glenny, Anne-Marie
author_sort	Yaacob, Munirah
title	Powered versus manual toothbrushing for oral health (Review)
title_short	Powered versus manual toothbrushing for oral health (Review)
title_full	Powered versus manual toothbrushing for oral health (Review)
title_fullStr	Powered versus manual toothbrushing for oral health (Review)
title_full_unstemmed	Powered versus manual toothbrushing for oral health (Review)
title_sort	powered versus manual toothbrushing for oral health (review)
publisher	Wiley-Blackwell
publishDate	2014
url	http://irep.iium.edu.my/37370/ http://irep.iium.edu.my/37370/ http://irep.iium.edu.my/37370/ http://irep.iium.edu.my/37370/4/37370_Powered%20versus%20manual%20toothbrushing%20for%20oral%20health_WOS.pdf http://irep.iium.edu.my/37370/10/37370_Powered%20versus%20manual%20toothbrushing%20for%20oral%20health.pdf
first_indexed	2023-09-18T20:53:37Z
last_indexed	2023-09-18T20:53:37Z
_version_	1777410158534590464
spelling	iium-373702017-09-14T03:55:49Z http://irep.iium.edu.my/37370/ Powered versus manual toothbrushing for oral health (Review) Yaacob, Munirah Worthington, Helen V. Deacon, Scott A. Deery, Chris Walmsley, Damien A. Robinson, Peter G. Glenny, Anne-Marie RK Dentistry Background Removing dental plaque may play a key role maintaining oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this. This is an update of a Cochrane review first published in 2003, and previously updated in 2005. Objectives To compare manual and powered toothbrushes in everyday use, by people of any age, in relation to the removal of plaque, the health of the gingivae, staining and calculus, dependability, adverse effects and cost. Search methods We searched the following electronic databases: the Cochrane Oral Health Group’s Trials Register (to 23 January 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 1), MEDLINE via OVID (1946 to 23 January 2014), EMBASE via OVID (1980 to 23 January 2014) and CINAHL via EBSCO (1980 to 23 January 2014). We searched the US National Institutes of Health Trials Register and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. Selection criteria Randomised controlled trials of at least four weeks of unsupervised powered toothbrushing versus manual toothbrushing for oral health in children and adults. Data collection and analysis We used standard methodological procedures expected by The Cochrane Collaboration. Random-effects models were used provided there were four or more studies included in the meta-analysis, otherwise fixed-effect models were used. Data were classed as short term (one to three months) and long term (greater than three months). Powered versus manual toothbrushing for oral health (Review) 1 Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Main results Fifty-six trials met the inclusion criteria; 51 trials involving 4624 participants provided data for meta-analysis. Five trials were at low risk of bias, five at high and 46 at unclear risk of bias. There is moderate quality evidence that powered toothbrushes provide a statistically significant benefit compared with manual tooth- brushes with regard to the reduction of plaque in both the short term (standardised mean difference (SMD) -0.50 (95% confidence interval (CI) -0.70 to -0.31); 40 trials, n = 2871) and long term (SMD -0.47 (95% CI -0.82 to -0.11; 14 trials, n = 978). These results correspond to an 11% reduction in plaque for the Quigley Hein index (Turesky) in the short term and 21% reduction long term. Both meta-analyses showed high levels of heterogeneity (I2 = 83% and 86% respectively) that was not explained by the different powered toothbrush type subgroups. With regard to gingivitis, there is moderate quality evidence that powered toothbrushes again provide a statistically significant benefit when compared with manual toothbrushes both in the short term (SMD -0.43 (95% CI -0.60 to -0.25); 44 trials, n = 3345) and long term (SMD -0.21 (95% CI -0.31 to -0.12); 16 trials, n = 1645). This corresponds to a 6% and 11% reduction in gingivitis for the Löe and Silness index respectively. Both meta-analyses showed high levels of heterogeneity (I2 = 82% and 51% respectively) that was not explained by the different powered toothbrush type subgroups. The number of trials for each type of powered toothbrush varied: side to side (10 trials), counter oscillation (five trials), rotation oscillation (27 trials), circular (two trials), ultrasonic (seven trials), ionic (four trials) and unknown (five trials). The greatest body of evidence was for rotation oscillation brushes which demonstrated a statistically significant reduction in plaque and gingivitis at both time points. Authors’ conclusions Powered toothbrushes reduce plaque and gingivitis more than manual toothbrushing in the short and long term. The clinical importance of these findings remains unclear. Observation of methodological guidelines and greater standardisation of design would benefit both future trials and meta-analyses. Wiley-Blackwell 2014-06 Article PeerReviewed application/pdf en http://irep.iium.edu.my/37370/4/37370_Powered%20versus%20manual%20toothbrushing%20for%20oral%20health_WOS.pdf application/pdf en http://irep.iium.edu.my/37370/10/37370_Powered%20versus%20manual%20toothbrushing%20for%20oral%20health.pdf Yaacob, Munirah and Worthington, Helen V. and Deacon, Scott A. and Deery, Chris and Walmsley, Damien A. and Robinson, Peter G. and Glenny, Anne-Marie (2014) Powered versus manual toothbrushing for oral health (Review). Cochrane Database of Systematic reviews 2014, The Cochrane Library, Cochrane Collaboration, 17 (6). pp. 1-140. ISSN 1469-493X E-ISSN 1361-6137 http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002281.pub3/epdf 10.1002/14651858.CD002281.pub3.

Powered versus manual toothbrushing for oral health (Review)

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