Sonic vs. manual toothbrushing in pediatric orthodontic patients

Objective: The aim of this clinical trial using a split-mouth design was to evaluate the effectiveness of Sonicare for Kids toothbrush (SFK) and manual toothbrush (MTB) concerning the plaque removal and the compliance level in pediatric orthodontic patients. Materials and methods: twenty-one subjects (13 female, 8 male, mean age 9), who were to receive orthodontic treatment with fixed appliances, were involved in the study. At baseline (T0) plaque index (PI) was assessed and each participant was given a SFK toothbrush and the instructions for a proper use of it (with “tell, show, do” technique). PI was re-evaluated after 1 (T1) and 3 (T2) months. After 6 months (T3), patients were re-instructed to brush correctly with both SFK and MTB; then, a plaque disclosing solution was applied and each subject was asked to brush in front of the mirror two quadrants with MTB and the contralateral quadrants with SFK. The choice of the quadrants was based on the hand predominantly used by every patient. After the brushing exercise was completed, PI was scored again and a satisfaction questionnaire about SFK and MTB was given to all participants. Paired t-test was used for the statistical analysis of T3 data. Results: the study showed an important mean reduction of PI after a month of use of SFK even if, without regular sessions of instruction and motivation, a new worsening was observed (T2). The amount of plaque removed was significantly higher in those quadrants brushed with SFK (74,6 %; t= 16,54%; p ≪ 0,01). Furthermore, the questionnaire indicated a preference towards the use of SFK. Conclusions: SFK can be considered an effective tool for daily biofilm removal but, regardless of the toothbrush used, a single session of instruction is not sufficient for the maintenance of good oral hygiene levels over time.