The relative effectiveness of six powered toothbrushes for dental plaque removal

During the past three years, a number of new powered toothbrushes have been marketed in the United States. The objective of this study was to compare the single-use plaque removal efficacy of six powered toothbrushes: a new prototype (Crest SpinBrush Pro), Crest SpinBrush, Oral-B Battery, Colgate Motion, Oral-B 3-D Excel, and a Crest experimental toothbrush design. This study was a randomized, controlled, examiner-blind, six-period crossover design, which examined plaque removal with six powered toothbrushes following a single use in 26 subjects. Plaque was scored before and after brushing for one minute using the Turesky, et al. Modification of the Quigley-Hein Index. For statistical comparison, the plaque scores were averaged on a per-subject basis. Each subject had a single whole-mouth average score for baseline and for the exam following a one-minute brushing with their assigned toothbrush. The difference (baseline minus post-brushing) in average scores was calculated and analyzed using an analysis of covariance for a crossover design, with baseline whole-mouth average score as the covariate, and terms in the model for subjects, periods, and treatments. Mean baseline plaque scores ranged from 1.770-1.897 for the six toothbrush treatment groups and were not statistically significantly different. Using the analysis of covariance, with respect to all surfaces examined, the new prototype powered toothbrush (Crest SpinBrush Pro) delivered an adjusted mean difference between baseline and post-brushing plaque scores of 0.544, while the five remaining powered toothbrushes delivered an adjusted mean difference of 0.470-0.497. These results represent 10-16% greater plaque removal for the new prototype powered toothbrush. Overall, the six toothbrushes were not statistically significantly different (p = 0.199). However, results of unadjusted pair-wise comparisons conducted per the study protocol found that the new prototype powered toothbrush removed greater levels of plaque than the Oral-B 3-D Excel, Colgate Motion, and Crest experimental toothbrush (p = 0.028, p = 0.038, and p = 0.028, respectively). With respect to buccal and lingual surfaces, the new prototype powered toothbrush (Crest SpinBrush Pro) delivered very similar results relative to the control toothbrushes. Collectively, the results suggest that the new prototype powered toothbrush may offer enhanced plaque removal efficiency relative to the five other toothbrushes, and be at least as good as the five tested powered toothbrushes.