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Updated: Apr 23, 2026

Oral Health Assessment by Lay Personnel for Older Adults
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Restoring Oral Hygiene Autonomy Through a Customized Toothbrush Handle in a Patient With Rheumatoid Arthritis and

Khalid Alfaifi1, Ali Robaian2, Abdulaziz Alsakr3

  • 1Saudi Board of Family Dentistry, College of Dentistry Prince Sattam Bin Abdulaziz University Al-Kharj Saudi Arabia.

Clinical Case Reports
|April 22, 2026
PubMed
Summary

Patients with rheumatoid arthritis (RA) and fibromyalgia (FM) can improve oral hygiene with custom toothbrush handles. This simple, chairside intervention significantly reduced plaque and discomfort, enhancing self-care.

Keywords:
disability and oral healthergonomic handlefibromyalgiaoral hygieneplaque indexrheumatoid arthritistoothbrush modification

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Area of Science:

  • Dentistry
  • Rheumatology
  • Occupational Therapy

Background:

  • Rheumatoid arthritis (RA) and fibromyalgia (FM) can cause functional limitations affecting oral hygiene.
  • Chronic joint pain and reduced dexterity in RA and FM patients impair basic oral care practices.
  • Early identification of these limitations is crucial for effective intervention.

Purpose of the Study:

  • To present a simple, cost-effective, and reproducible chairside intervention for improving oral hygiene in patients with RA and FM.
  • To demonstrate the efficacy of a customized, adaptive toothbrush handle in enhancing brushing efficiency and comfort.

Main Methods:

  • Chairside fabrication of a soft putty toothbrush handle, custom-molded to the patient's specific grip.
  • Application of the adaptive handle for a patient with RA and FM experiencing poor plaque control and brushing discomfort.
  • Assessment of plaque index and self-reported discomfort (VAS score) pre- and post-intervention.

Main Results:

  • Significant improvement in plaque index, decreasing from 91% to 15% within four months.
  • Substantial reduction in brushing-associated discomfort, with VAS scores dropping from 5 to 1.
  • The customized ergonomic handle enhanced brushing efficiency, comfort, and self-care independence.

Conclusions:

  • Personalized, adaptive oral hygiene aids are vital for medically compromised populations.
  • Chairside fabrication of custom toothbrush handles offers a practical solution for patients with RA and FM.
  • This intervention significantly improves oral self-care outcomes and quality of life.