An evaluation of video instruction for an electric toothbrush. Comparative single-brushing cross-over study

Instructions on the use of electric toothbrushes are usually derived from the written and/or diagrammatic leaflets provided with the device or perhaps less often instruction from a professional. Videos are now widely used for information transfer and the direction of physical activities. The aim of this study was to determine whether video instruction in the use of an electric toothbrush could promote efficient use of the device. The 2-min video demonstrated the use of an oscillating, rotating electric toothbrush used by a hygienist for 15 s in each buccal and lingual quadrant. A voice-over directed the observer to follow the hygienist's movements. The study was planned as a 2-phase, single-examiner blind, randomised, cross-over study accepting there would be confounding of the 2nd period by carry-over from the 1st. A group of 24 healthy volunteers participated who had average oral hygiene and never used an electric toothbrush. 12 subjects received the video first (VN) and 12 subjects the instructional leaflet with the device (NV). Single brushings were performed after suspending tooth cleaning for 48 h. Plaque was scored before and after brushing. A 2-week washout period was permitted before the crossover. In period 1, plaque removal with the video was overall significantly greater than with written instructions. The effects for posterior teeth were greater than anterior and comparison between groups for posterior minus anterior differences were highly significant in favour of the VN group. In period 2, the effect of period was dominant with both groups achieving greater plaque removal in period 2 than period 1. Plaque removal by group VN remained considerably greater than group NV Despite the confounding influences of carry-over in this particular design of study, the results support the idea that video instruction for electric toothbrushes could be a simple and efficient way of improving plaque removal by these devices. The methodology needs to be verified in a home-use type of investigation.