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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.
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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.
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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 review
5
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:
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• 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
2