Electric toothbrush for biofilm control in individuals with Down syndrome: a crossover randomized clinical trial

Abstract Poor oral hygiene seems to be the norm in children and teenagers with Down Syndrome (DS). Advances in design and types of toothbrushes may improve biofilm control. This randomized, single-blind, crossover clinical trial evaluated the effectiveness of electric toothbrushes regarding mechanical control of biofilm in children and teenagers with DS and their cooperation. Twenty-nine participants with DS, aged 6 to 14 years, used both types of toothbrushes: electric (ET) and manual (MT). The order of use of the different types of toothbrushes was randomly defined, including a 7-day period with each type with 7-day washout period in between. The Turesky-Quigley-Hein biofilm index was used before and after brushing to assess the effectiveness of the technique. Frankl’s behavioral scale was used during toothbrushing to assess the participants’ cooperation. Paired T-test, Mann Whitney, Chi-square, and Fisher’s Exact tests were applied, with a significance level of 5%. The quantity of dental biofilm was significantly reduced after both brushing techniques (p < 0.001). However, no significant difference was found in total biofilm (ET: 0.73 ± 0.36; MT: 0.73 ± 0.34; p = 0.985) or % biofilm reduction (ET: 72.22%; MT: 70.96%; p = 0.762) after brushing between techniques or in % biofilm reduction between toothbrushes of age groups (6 –9 years, p = 0.919; 10–14 years, p = 0.671). Participants showed similar cooperation level with the two types of toothbrush (p = 1.000). The use of electric or manual toothbrush had no effect on the quantity of dental biofilm removed in children and teenagers with DS, nor did it influence their cooperation during the procedure.

摘要：唐氏综合征（Down Syndrome, DS）患儿及青少年群体普遍存在口腔卫生状况不佳的问题。牙刷设计与品类的革新或可改善牙菌斑管控效果。本项随机单盲交叉临床试验，旨在评估电动牙刷针对唐氏综合征患儿及青少年的牙菌斑机械清除效果，以及受试对象的配合度。本研究共纳入29名6~14岁的唐氏综合征受试对象，所有受试者均使用电动牙刷（electric toothbrush, ET）与手动牙刷（manual toothbrush, MT）两种工具。两种牙刷的使用顺序随机分配，每种牙刷各使用7天，期间设置7天的洗脱期。研究采用Turesky-Quigley-Hein菌斑指数，分别于刷牙前后评估菌斑清除效果；刷牙过程中采用Frankl行为量表评估受试对象的配合程度。本研究采用配对t检验、Mann-Whitney U检验、卡方检验以及Fisher确切概率法进行统计分析，检验水准设定为5%。两种刷牙方式均可显著减少牙菌斑量（p < 0.001）。不过，两种刷牙方式在刷牙后总菌斑量[电动牙刷：0.73±0.36；手动牙刷：0.73±0.34；p = 0.985]及菌斑清除率[电动牙刷：72.22%；手动牙刷：70.96%；p = 0.762]上均无显著差异；按年龄分层（6~9岁组、10~14岁组）后，两组牙刷的菌斑清除率亦无显著差异（6~9岁组：p = 0.919；10~14岁组：p = 0.671）。受试对象使用两种牙刷时的配合程度无显著差异（p = 1.000）。综上，针对唐氏综合征患儿及青少年群体，电动牙刷与手动牙刷在牙菌斑清除量上无显著差异，且对刷牙过程中的配合程度亦无明显影响。