Manual versus powered toothbrushing for oral health

Research output: Contribution to journalReview articlepeer-review

Standard

Manual versus powered toothbrushing for oral health. / Heanue, M; Deacon, SA; Deery, C; Robinson, PG; Walmsley, Anthony; Worthington, HV; Shaw, WC.

In: Cochrane Database of Systematic Reviews, No. 1, CD002281, 01.01.2003.

Research output: Contribution to journalReview articlepeer-review

Harvard

Heanue, M, Deacon, SA, Deery, C, Robinson, PG, Walmsley, A, Worthington, HV & Shaw, WC 2003, 'Manual versus powered toothbrushing for oral health', Cochrane Database of Systematic Reviews, no. 1, CD002281. https://doi.org/10.1002/14651858.CD002281

APA

Heanue, M., Deacon, SA., Deery, C., Robinson, PG., Walmsley, A., Worthington, HV., & Shaw, WC. (2003). Manual versus powered toothbrushing for oral health. Cochrane Database of Systematic Reviews, (1), [CD002281]. https://doi.org/10.1002/14651858.CD002281

Vancouver

Author

Heanue, M ; Deacon, SA ; Deery, C ; Robinson, PG ; Walmsley, Anthony ; Worthington, HV ; Shaw, WC. / Manual versus powered toothbrushing for oral health. In: Cochrane Database of Systematic Reviews. 2003 ; No. 1.

Bibtex

@article{873e4af044094aafbb80d1185efc9c12,
title = "Manual versus powered toothbrushing for oral health",
abstract = "BackgroundSpecific oral bacteria, generically known as 'dental plaque' are the primary cause of gingivitis (gum disease) and caries. The removal of dental plaque is thought to play a key role in the maintenance of oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this.ObjectivesTo compare manual and powered toothbrushes in relation to the removal of plaque, the health of the gingivae, staining and calculus, dependability, adverse effects and cost.Search strategyWe searched the Cochrane Oral Health Group's Trials Register (to 22/8/02); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2002); MEDLINE (January 1966 to week 5 2002); EMBASE (January 1980 to week 3 July 2002) and CINAHL (January 1982 to June 2002). Manufacturers of powered toothbrushes were contacted for additional published and unpublished trials.Selection criteriaTrials were selected if they met the following criteria: design-random allocation of participants; participants-general public with uncompromised manual dexterity; intervention- unsupervised manual and powered toothbrushing for at least 4 weeks; primary outcomes-the change in plaque and gingivitis over that period.Data collection and analysisSix reviewers independently extracted information in duplicate. Indices for plaque and gingivitis were expressed as standardised values for each study. The effect measure for each meta-analysis was the standardised mean difference (SMD) with the appropriate 95% confidence intervals (CI) using random effects models. Potential sources of heterogeneity were examined, along with sensitivity analyses for the items assessed for quality and publication bias.Main resultsTwenty-nine trials, involving 2547 participants, provided data for the meta-analysis.Brushes that worked with a rotation oscillation action removed more plaque and reduced gingivitis more effectively than manual brushes in the short and long term. For plaque at 1 to 3 months the SMD was -0.44 (95% CI: -0.66 to -0.21), for gingivitis SMD -0.45 (95% CI: -0.76, -0.15). These represented an 11% reduction on the Quigley Hein plaque index and a 6% reduction on the L{\"o}e and Silness gingival index. At over 3 months the effects were SMD for plaque -1.15 (95% CI: -2.02,-0.29) and SMD for gingivitis -0.51 (95% CI: -0.76, -0.25). These represented a 7% reduction on the Quigley Hein Plaque Index and a 17% reduction on the Ainamo Bay Bleeding on Probing Gingival Index. The heterogeneity found in these meta-analyses for short term trials was caused by one trial that had exceptionally low standard deviations. Sensitivity analyses revealed the results to be robust when selecting trials of high quality. There was no evidence of any publication bias.No other powered brush designs were consistently superior to manual toothbrushes.In these trials, data on cost, reliability and side effects were inconsistently reported. Those side effects that were reported on in the trials were localised and temporary.Authors' conclusionsPowered toothbrushes with a rotation oscillation action achieve a modest reduction in plaque and gingivitis compared to manual toothbrushing.Observation of methodological guidelines and greater standardisation of design would benefit both future trials and meta-analyses.",
author = "M Heanue and SA Deacon and C Deery and PG Robinson and Anthony Walmsley and HV Worthington and WC Shaw",
year = "2003",
month = jan,
day = "1",
doi = "10.1002/14651858.CD002281",
language = "English",
journal = "Cochrane Database of Systematic Reviews",
issn = "1469-493X",
publisher = "Cochrane Collaboration",
number = "1",

}

RIS

TY - JOUR

T1 - Manual versus powered toothbrushing for oral health

AU - Heanue, M

AU - Deacon, SA

AU - Deery, C

AU - Robinson, PG

AU - Walmsley, Anthony

AU - Worthington, HV

AU - Shaw, WC

PY - 2003/1/1

Y1 - 2003/1/1

N2 - BackgroundSpecific oral bacteria, generically known as 'dental plaque' are the primary cause of gingivitis (gum disease) and caries. The removal of dental plaque is thought to play a key role in the maintenance of oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this.ObjectivesTo compare manual and powered toothbrushes in relation to the removal of plaque, the health of the gingivae, staining and calculus, dependability, adverse effects and cost.Search strategyWe searched the Cochrane Oral Health Group's Trials Register (to 22/8/02); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2002); MEDLINE (January 1966 to week 5 2002); EMBASE (January 1980 to week 3 July 2002) and CINAHL (January 1982 to June 2002). Manufacturers of powered toothbrushes were contacted for additional published and unpublished trials.Selection criteriaTrials were selected if they met the following criteria: design-random allocation of participants; participants-general public with uncompromised manual dexterity; intervention- unsupervised manual and powered toothbrushing for at least 4 weeks; primary outcomes-the change in plaque and gingivitis over that period.Data collection and analysisSix reviewers independently extracted information in duplicate. Indices for plaque and gingivitis were expressed as standardised values for each study. The effect measure for each meta-analysis was the standardised mean difference (SMD) with the appropriate 95% confidence intervals (CI) using random effects models. Potential sources of heterogeneity were examined, along with sensitivity analyses for the items assessed for quality and publication bias.Main resultsTwenty-nine trials, involving 2547 participants, provided data for the meta-analysis.Brushes that worked with a rotation oscillation action removed more plaque and reduced gingivitis more effectively than manual brushes in the short and long term. For plaque at 1 to 3 months the SMD was -0.44 (95% CI: -0.66 to -0.21), for gingivitis SMD -0.45 (95% CI: -0.76, -0.15). These represented an 11% reduction on the Quigley Hein plaque index and a 6% reduction on the Löe and Silness gingival index. At over 3 months the effects were SMD for plaque -1.15 (95% CI: -2.02,-0.29) and SMD for gingivitis -0.51 (95% CI: -0.76, -0.25). These represented a 7% reduction on the Quigley Hein Plaque Index and a 17% reduction on the Ainamo Bay Bleeding on Probing Gingival Index. The heterogeneity found in these meta-analyses for short term trials was caused by one trial that had exceptionally low standard deviations. Sensitivity analyses revealed the results to be robust when selecting trials of high quality. There was no evidence of any publication bias.No other powered brush designs were consistently superior to manual toothbrushes.In these trials, data on cost, reliability and side effects were inconsistently reported. Those side effects that were reported on in the trials were localised and temporary.Authors' conclusionsPowered toothbrushes with a rotation oscillation action achieve a modest reduction in plaque and gingivitis compared to manual toothbrushing.Observation of methodological guidelines and greater standardisation of design would benefit both future trials and meta-analyses.

AB - BackgroundSpecific oral bacteria, generically known as 'dental plaque' are the primary cause of gingivitis (gum disease) and caries. The removal of dental plaque is thought to play a key role in the maintenance of oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this.ObjectivesTo compare manual and powered toothbrushes in relation to the removal of plaque, the health of the gingivae, staining and calculus, dependability, adverse effects and cost.Search strategyWe searched the Cochrane Oral Health Group's Trials Register (to 22/8/02); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2002); MEDLINE (January 1966 to week 5 2002); EMBASE (January 1980 to week 3 July 2002) and CINAHL (January 1982 to June 2002). Manufacturers of powered toothbrushes were contacted for additional published and unpublished trials.Selection criteriaTrials were selected if they met the following criteria: design-random allocation of participants; participants-general public with uncompromised manual dexterity; intervention- unsupervised manual and powered toothbrushing for at least 4 weeks; primary outcomes-the change in plaque and gingivitis over that period.Data collection and analysisSix reviewers independently extracted information in duplicate. Indices for plaque and gingivitis were expressed as standardised values for each study. The effect measure for each meta-analysis was the standardised mean difference (SMD) with the appropriate 95% confidence intervals (CI) using random effects models. Potential sources of heterogeneity were examined, along with sensitivity analyses for the items assessed for quality and publication bias.Main resultsTwenty-nine trials, involving 2547 participants, provided data for the meta-analysis.Brushes that worked with a rotation oscillation action removed more plaque and reduced gingivitis more effectively than manual brushes in the short and long term. For plaque at 1 to 3 months the SMD was -0.44 (95% CI: -0.66 to -0.21), for gingivitis SMD -0.45 (95% CI: -0.76, -0.15). These represented an 11% reduction on the Quigley Hein plaque index and a 6% reduction on the Löe and Silness gingival index. At over 3 months the effects were SMD for plaque -1.15 (95% CI: -2.02,-0.29) and SMD for gingivitis -0.51 (95% CI: -0.76, -0.25). These represented a 7% reduction on the Quigley Hein Plaque Index and a 17% reduction on the Ainamo Bay Bleeding on Probing Gingival Index. The heterogeneity found in these meta-analyses for short term trials was caused by one trial that had exceptionally low standard deviations. Sensitivity analyses revealed the results to be robust when selecting trials of high quality. There was no evidence of any publication bias.No other powered brush designs were consistently superior to manual toothbrushes.In these trials, data on cost, reliability and side effects were inconsistently reported. Those side effects that were reported on in the trials were localised and temporary.Authors' conclusionsPowered toothbrushes with a rotation oscillation action achieve a modest reduction in plaque and gingivitis compared to manual toothbrushing.Observation of methodological guidelines and greater standardisation of design would benefit both future trials and meta-analyses.

U2 - 10.1002/14651858.CD002281

DO - 10.1002/14651858.CD002281

M3 - Review article

JO - Cochrane Database of Systematic Reviews

JF - Cochrane Database of Systematic Reviews

SN - 1469-493X

IS - 1

M1 - CD002281

ER -