Comparative Plaque Removal Efficacy of a Power and a Manual Toothbrush Among Children With Cerebral Palsy - A Crossover Randomised Control Trial

Objective: To assess the plaque removal efficacy of Power toothbrush versus manual toothbrush evaluated by improvement in oral hygiene status of 12-15 year age children with Cerebral Palsy. Methods: A crossover randomized controlled trial with three month study duration on eighty Cerebral Palsy children were divided into two groups. Plaque index, gingival index & Oral Hygiene Index Simplified (OHI-S) used at baseline. The group I received a manual toothbrush and group II received Power toothbrush. After 4 weeks, parameters were reassessed. After 1 month washout, interventions were crossed-over. After 4 weeks markers were again recorded. The scores were compared and analyzed from baseline, after phase-I and phase-II. Results: Between group comparison showed no significant change at the end of phase-I (p>0.05). The median decreased from baseline pre intervention PI=2.0, GI=2.0 & OHI-S=3.5 to post intervention PI=1.45, GI=1.00 & OHI-S=1.90 for power brush and for manual brush pre intervention PI=2.00, GI=2.00, OHI-S=2.9 to post intervention PI=1.00, GI=0.90, OHI-S=1.25). After exchange of brushes there was a significant change at the end of phase-II (p<0.05).Highly significant for Post PI (p=0.000) and Post GI (p=0.000) and Post OHIS (p=0.002). The medians decreased from pre intervention PI=1.25, GI=1.00, OHIS=1.50 to PI=0.80, GI=0.35, OHIS=0.95 for power brush and PI=1.65, GI=1.30, OHIS=2.05 to PI=1.50, GI=1.15, OHIS=1.80 for manual brush. Within group comparison showed highly statistically significant values for both the groups. (p=<0.000). Median difference was greater for the power brush irrespective of the order of intervention given. Conclusion: The study shows that both the Power Brush and Manual Brush brought statistically significant reduction in oral parameters. However the median difference values were greater by the use of power brush. Trial registration: www.clinicaltrials.gov - Registration no. NCT05768568 (17-9-2021)