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Interspace/interdental brushes for oral hygiene in orthodontic patients with fixed appliancesGoh HH, Fernandez Mauleffinch LM
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SummaryInterspace/interdental brushes for oral hygiene in orthodontic patients with fixed appliancesPatients with fixed orthodontic braces need to make extra efforts to keep their teeth clean. It has been recommended by dentists and hygienists that special interdental or interspace brushes are required to maintain clean teeth. These special brushes and the braces mean that toothbrushes need replacing more frequently and therefore mean an increase in cost. There is no evidence to show that this recommendation is supported by clinical investigations.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2009 Issue 4, Copyright © 2009 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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July 18. 2007 AbstractBackgroundAccumulation of plaque on tooth surfaces that have fixed orthodontic appliances is increased. Effective removal is essential to maintain oral health but it is unclear whether the use of interdental or interspace brushes is useful. ObjectivesTo compare the effectiveness of standard toothbrushes with combined standard toothbrushes and interdental/interspace brushes used by patients during fixed orthodontic appliances therapy in relation to plaque removal, the health of dental and supporting tissues, dependability, cost and adverse effects. Search strategyWe searched the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE, EMBASE and CINAHL. Schools of dental hygiene were contacted for additional data. No language restrictions were applied. Handsearching of the relevant journals was carried out. Most recent search: January 2006. Selection criteriaRandomised controlled trials (RCTs) including the following criteria: participants - patients with fixed orthodontic appliances and uncompromised manual dexterity; intervention - unsupervised toothbrushing with standard toothbrush alone versus standard toothbrush and interdental/interspace brush. Primary outcomes were differences in plaque control, gingival health and decalcification. Data collection and analysisScreening of eligible studies, assessment of the methodological quality of the trials and data extraction were to be conducted in duplicate and independently. Trials were to be grouped in terms of their interventions and outcome measures. Results were to be expressed as random-effects models using standardised mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals. Heterogeneity was to be investigated. Main resultsNo studies were identified to support or contest the null hypothesis. Authors' conclusionsThe present practice of recommending the use of interdental/interspace brushes in addition to standard toothbrushes is not supported by clinical investigations. Interdental brushes and normal toothbrushes wear is increased during orthodontic treatment and brushes need to be replaced more frequently. This increases the economic burden of oral hygiene products for the patient. |