Effect of instruction and motivation in the use of electric and manual toothbrushes in periodontal patients. A comparative study.

The aim of the present study was to evaluate the efficacy of manual and electric toothbrushes in plaque control in periodontal patients after proper instructions. Thirty six periodontal patients (mean age of 49 years, 21 females and 15 males) were included and completed the study (100% compliance). A single-blinded, randomized, controlled, cross-over clinical design was adopted, with the patients using during 2 periods of 14 days each the manual and/or electric toothbrush. Four subgroups of 9 individuals were studied: A1--used manual toothbrush in both experimental periods; A2--used the manual toothbrush during the first period and the electrical toothbrush during the second period; B1--used electrical toothbrush during both periods; B2--used the electrical toothbrush in the first period and the manual one in the second period. Brushing was performed during 14 days and at day 14 and 28 it was performed in the clinic, and timing of brushing was recorded without patients being aware. The Plaque Index (Silness, Löe, 1964) was used. Intra-group comparisons were performed by paired t-test and inter-group comparisons by independent sample t-test, with an alpha level of 0.05. The results showed no difference between the tested brushes neither for plaque nor for timing. However, re-instruction was detected as an important factor, since for all groups the second period, after reinstruction, showed lower plaque scores. It is concluded that professional advice and instruction and re-instruction seem more important in order to obtain good plaque control than the choice of toothbrush in subjects with periodontal disease.