Three years long-term impact of powered vs. manual toothbrushes on hypersensitivity and gingival recession: A randomized controlled trial

Abstract

Objectives: Gingival recessions (GR) are often associated with dentin hypersensitivity (HYP) and can significantly affect patients' oral health-related quality of life. This subgroup-analysis of a previously published study assesses the long-term effects of oscillating-rotating powered (PT) and manual toothbrushes (MT) on HYP in teeth with pre-existing GR and no interproximal attachment loss (RT1) over 36 months.

Methods: Ninety participants with RT1 were divided into PT-/MT-group (n = 47/n = 43). All participants brushed twice daily with the same fluoride toothpaste. HYP scores were reassessed for 180 index teeth (PT/MT: n = 94/n = 86); two teeth per participant. HYP was evaluated annually (T0(baseline), T1, T2 and T3) using tactile stimulus with a dental probe (HYP-S) and an air-jet (HYP-L) applied to the index teeth.

Results: At T3, HYP-L was significantly reduced in PT but not in MT (p = 0.014). From T0 to T3, 60 % of PT users showed a decrease in HYP-L, 6.4 % remained stable, and 33 % experienced an increase, whereas in MT, 36 % showed a reduction, 18.6 % remained stable, and 45.5 % experienced an increase. This was consistent with the GR stabilization reported in the primary analysis. Between T0 to T3 smokers showed a significantly greater reduction in HYP-L than non-smokers (-1.17(1.49) vs. 0.10(2.27); p = 0.006), regardless of toothbrush group. Male participants exhibited a more pronounced reduction in HYP-S compared to females (-0.09(1.85) vs. -0.04(1.11); p = 0.021).

Conclusions: The tested powered toothbrush reduced HYP-L more than manual toothbrushing over 36 months; HYP-S was unaffected. Findings are exploratory and require confirmation.

Clinical significance: Over 36 months, oscillating-rotating powered brushing was associated with a reduction in air-jet-induced dentin hypersensitivity at RT1-type gingival recession sites. The effect is small and exploratory; powered brushing appears safe in this population but should not be recommended on the basis of hypersensitivity reduction until confirmed in a trial prospectively powered for that endpoint.

Trial registration: This study was prospectively registered in the German Clinical Trials Register (DRKS00015133) on July 25, 2018.

Keywords: Dentin hypersensitivity; Erosive dietary habits; Gingival recession; Manual toothbrush; Oral hygiene; Powered toothbrush; Randomized controlled trial.