Plaque Removal Efficacy of Electric Toothbrushes in ADHD
Condition: Attention Deficit and Hyperactivity Disorder; Dental Plaque
MeSH terms: Dental Plaque; Hyperkinesis; Attention Deficit Disorder with Hyperactivity
Study type: Interventional

Summary: 
      A total of 52 children, 26 of whom were diagnosed with Attention Deficit Hyperactivity
      Disorder (ADHD) as the experimental group and 26 healthy with no systemic disease as the
      control group, were included in the study. Then, in order to evaluate the effectiveness of
      electric and manual toothbrushes, each group was randomly divided into 2 subgroups: Electric
      and Manual. Children were educated on toothbrushing according to subgroups. DMFT/dft and
      Löe-Silness Gingival Index (GI) values were recorded. At the first appointment, plaque
      disclosing was performed and Turesky modification of Quigley-Hein Plaque Index (TQHPI) and
      Approximal Plaque Index (API) values were recorded to determine the amount of dental plaque
      before the brushing. Subsequently, children brushed their teeth for 2 minutes with the
      subgroup's toothbrush type. Then, plaque disclosing and measurements were repeated to
      determine the amount of plaque removal after brushing. The same procedure steps were repeated
      at the 1st and 3rd-month appointments, respectively. a p-value below 0.05 was considered
      statistically significant.
    

Detailed description: 
      A total of 52 children, 26 of whom were diagnosed with ADHD, as the experimental group and 26
      of whom were healthy, as the control group, were included in the study. Intraoral examination
      of the children was performed in a dental chair. Standard coding systems and tools developed
      by the World Health Organization were used to collect data in calculating the criteria for
      oral health. Soft tissues, tongue, cheek, and palate area were checked in each examination
      period. Intraoral examination was performed carefully, from the distal right maxillary molars
      to the most distal right mandibular molars. If there was no cavitation with white spot
      lesions and black/dark and bright discolorations were considered healthy. According to the
      DMFT index (Decayed, Missing, and Filled Teeth Index) with the obtained records, DMFT values
      for permanent teeth and dft values for primary teeth were calculated.

      Randomization of the patients to determine the subgroups was carried out by the physician who
      performed the first examination (B.M.A) using a computer program called www.Random.org
      (Randomness and Integrity Services Ltd., Ireland). In order to evaluate the effectiveness of
      electric and manual toothbrushes, each group was divided into 2 subgroups according to the
      types of brush (electric and manual). There are a total of 4 subgroups in the study. In the
      manual toothbrush subgroups, the children had a demonstration of how to brush with the Bass
      Technique on the model. The electric toothbrush subgroups had a demonstration about how to
      brush their teeth with an electric toothbrush according to the manufacturer's instructions on
      the model. During the study, children brushed their teeth at home under parental supervision.
      It is instructed to brush teeth for 2 minutes 2 times a day. During the study period,
      Sensodyne Promine Kids (GlaxoSmithKline Brazil Ltda, Jacarepagua, Rio de Janeiro, Brazil)
      were given to children. In both the experimental and control groups and their parents had
      received instruction to avoid oral hygiene procedures such as flossing and using mouthwash
      during the study period, except tooth brushing.

      After randomization, at the first appointment, Löe-Silness Gingival Index values were
      recorded in all fully erupted permanent teeth and primary teeth without exfoliation. In order
      to determine the amount of dental plaque before the first brushing, Mira-2-Ton Plaque
      Staining Solution (Hager Werken, Germany) was applied to the labial and lingual surfaces of
      all teeth with a micro brush, and then the children were asked to rinse their mouths with
      water for 30 seconds. After plaque discoloration, the Approximal Plaque Index and the Turesky
      Modification of Quigley-Hein Plaque Index values were recorded. The children brushed their
      teeth in front of a mirror for 2 minutes with the toothbrushes according to subgroups, under
      the supervision of a physician who was not included in the study. To determine the amount of
      plaque removal after the first brushing, plaque discoloration was performed again. The
      Turesky modification of the Quigley-Hein Plaque Index and the Approximal Plaque Index
      measurements were recorded. The same procedures were repeated to evaluate the brushing habits
      at the 1st-month and 3rd-month, respectively.
    

Intervention name(s): Plaque removal efficacy of children's electric toothbrush (Oral-B D100 Vitality; Procter & Gamble, Cincinnati, OH, United States); Plaque removal efficacy of children's soft manual toothbrush (Oral-B Stages 6-12 years; Procter & Gamble, Cincinnati, OH, United States)
Intervention type(s): Device; Device
Intervention description(s): At the baseline appointment, Löe-Silness Gingival Index values were recorded in all fully erupted permanent teeth and primary teeth without exfoliation. Mira-2-Ton Plaque Staining Solution was applied to the labial and lingual surfaces of all teeth with a micro brush to determine the amount of dental plaque before the first brushing. After plaque discoloration, the Approximal Plaque Index and the Turesky Modification of Quigley-Hein Plaque Index values were recorded. The children brushed their teeth with an electric toothbrush for 2 minutes, under the supervision of a physician who was not included in the study. Plaque discoloration was performed again to determine the amount of plaque removal after the first brushing. Approximal Plaque Index and The Turesky modification of the Quigley-Hein Plaque Index the measurements were recorded. The same procedures were repeated to evaluate the brushing habits at the 1st-month and 3rd-month, respectively.; At the baseline appointment, Löe-Silness Gingival Index values were recorded in all fully erupted permanent teeth and primary teeth without exfoliation. Mira-2-Ton Plaque Staining Solution was applied to the labial and lingual surfaces of all teeth with a micro brush to determine the amount of dental plaque before the first brushing. After plaque discoloration, the Approximal Plaque Index and the Turesky Modification of Quigley-Hein Plaque Index values were recorded. The children brushed their teeth with a manual toothbrush for 2 minutes, under the supervision of a physician who was not included in the study. Plaque discoloration was performed again to determine the amount of plaque removal after the first brushing. Approximal Plaque Index and The Turesky modification of the Quigley-Hein Plaque Index the measurements were recorded. The same procedures were repeated to evaluate the brushing habits at the 1st-month and 3rd-month, respectively.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Prevention