oral hygiene, manual toothbrushes, powered toothbrushes, orthodontic patients, interproximal plaque control, dental floss, interproximal brushes
All methods aimed at achieving ideal plaque control should include two aspects: toothbrushing and interdental tooth cleaning.
No scientific evidence has been found to support the consistent superiority of a particular manual toothbrush. However the results observed with the newly designed models should be carefully studied in the future. Long-term studies are needed. Nevertheless, there appears to be evidence that supports the use of powered toothbrushes in the general population, especially those of the oscillating-rotating and counter-rotational type, as they have shown their ability to reduce gingival bleeding or inflammation, and dental plaque with greater efficacy than manual brushes.
There is a need for long-term trials on the efficacy of powered brushes in orthodontic patients. We can conclude from existing studies that there is limited evidence that orthodontic patients using a powered toothbrush show a slight, but significant, reduction of bleeding, compared with users of manual brushes. No conclusion can be made concerning the type of brush to be used.
The techniques of interproximal oral hygiene, fundamentally the use of dental floss and interproximal brushes, when they are associated with conventional manual brushes, appear to add additional benefits in terms of plaque reduction. Further long-term studies are necessary to confirm their efficacy in the reduction of gingival bleeding or inflammation. The choice of the type of technique must be made in relation to the characteristics of the patient: dental floss could be indicated in individuals with closed interdental spaces, and interproximal brushes in periodontal patients or in those with open embrasures.