Efficacy of an Electric Toothbrush With Monitor in Dental Plaque Removal: A Crossover Randomized Controlled Trial

Abstract

Background and purpose: Plaque control is very important in the treatment of periodontitis. However, plaque is difficult to remove because one cannot see one's own oral cavity. The purpose of this study was to verify the plaque removal effect of a prototype device that has a built-in image sensor in the head of an electric toothbrush, enabling the user to brush while checking the condition of the tooth surface on a monitor in real time and to assess their sense of use.

Materials and methods: The subjects were 10 fifth-year students from the Graduate School of Dental Science, Fukuoka Dental College, Fukuoka, Japan. The subjects were divided into those who used electric toothbrushes while having the condition of the tooth surface checked with a monitor (monitor group) and those without a monitor (non-monitor group). O'Leary plaque control records before and after brushing and the brushing time were measured, and questionnaires were given to the subjects after brushing. Scaling and professional tooth cleaning were performed after completing the questionnaire. One week later, subjects were switched to the opposite group and had the same measurements and questionnaires. The Wilcoxon signed-rank test was used to compare both groups before and after the examination at a 5% significance level.

Results: The monitor group had significantly better plaque removal than the non-monitor group. In addition, the monitor group spent significantly more time brushing than the control group.

Conclusion: Brushing while monitoring oral conditions in real time using an electric toothbrush with a built-in image sensor showed that significantly better plaque removal can be achieved with a longer brushing time.

Keywords: biofilm; electric toothbrush; image sensor; oral hygiene; plaque-removal effect.

Figure 1. Prototype of the electric toothbrush in this study

A. Electric toothbrush with a camera and display device. An image sensor is equipped in the head of the toothbrush. B. Display device image. Actual image displayed on the device monitor. Bristles of the brush are seen in the circumferential area.

Figure 2. CONSORT flow and informed consent

CONSORT: Consolidated Standards of Reporting Trials; n: number of participants

Figure 3. Experimental schedule

PMTC: professional mechanical tooth cleaning

Figure 4. Plaque control record

Plaque control record change between before and after brushing (including both groups A and B). Wilcoxon signed-rank test, vs. before brushing, ** p<0.01, *** p<0.001

Figure 5. Plaque removal rate and tooth brushing time

A. Plaque removal rate in groups with or without monitor. Wilcoxon signed-rank test, vs. the non-monitor group, ** p<0.01. B. Tooth brushing time in groups with or without monitor. Wilcoxon signed-rank test, vs. the non-monitor group, * p<0.05

Figure 6. Results of the questionnaire