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

Objectives: 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).

Materials And Methods: 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.

Results: 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.

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

Clinical Relevance: 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.