# Cleansing efficacy of an auto-cleaning device versus an oscillating- rotating toothbrush in home use. A pilot study in individuals with down syndrome

## TL;DR

A pilot study found no significant difference in plaque removal between automatic and oscillating toothbrushes used by people with Down syndrome at home.

## Contribution

The study evaluates the effectiveness of automatic toothbrushes for individuals with Down syndrome in unassisted home use.

## Key findings

- No statistically significant difference in plaque index between automatic and oscillating toothbrushes after four weeks.
- Both brushing methods resulted in unsatisfactory plaque control in unassisted home use.
- Plaque index improved from baseline with automated brushing but not enough to be clinically significant.

## Abstract

People with intellectual disabilities often have poor oral hygiene and depend on carers’ support. We aimed to investigate, whether automatic toothbrushes could benefit people with Down syndrome (DS).

In a randomized, single-blinded cross-over study we compared the cleansing efficacy of a horse-shoe shaped automatic toothbrush with that of rotating-oscillating toothbrushing in unassisted domestic use over four weeks by persons with DS. Rustogi Modified Navy Plaque Index (RMNPI) and Gingival Bleeding Index (GBI) were assessed before and after each intervention period. Wilcoxon Signed-Rank Test was used for statistical analysis.

Fifteen participants (mean age 31 ± 8.33 years) finished the study. There were no statistically significant differences in RMNPI between the two brushing modalities after four weeks of unassisted home use, neither in full mouth (Y-brush®: median 59.2%; range 24.8 – 76.7; rotating-oscillating toothbrush: 54.6%; 6.4 – 71.3) (p = 0.484) nor in subgroup analyses. RMNPI was statistically significantly higher after four weeks of automated brushing than baseline. There was no statistically significant difference for full-mouth GBI between the two brushing modalities.

Both, oscillating-rotating and automated toothbrushing resulted in unsatisfactory plaque control after unassisted use by people with DS.

Further studies should investigate the impact of caregivers’ assistance with auto-cleaning devices to persons with disabilities on plaque removal efficacy. Customization of mouthpieces and simplification of handling modalities might effect a higher cleansing capacity and should be future goals for automatic brushing device manufacturers.