Professor of periodontology, University of Alberta, Canada.
When we are practicing dentistry,
many times, we are used to hearing our
colleagues say: ‘it works in my hands’
or, ‘I believe in this material’ or, ‘this
is how I have been doing it for years’.
And usually we feel that it really does
work in our hands. However, we need to remember, that even
when we feel ‘it works in our hands’ or even when we truly
believe in a specific product or treatment modality, it is not
always necessarily the case. We actually need to collect
data properly and to analyze it in a way that will be
comprehensive and unbiased.
When we are talking about evidence-based practice, there is a pyramid reflecting levels of evidence that we are referring to (Figure 1). This pyramid starts with in vitro lab research and goes through increasing levels of evidence until it reaches the top of the pyramid
where systematic reviews and meta-analysis are.
In systematic
reviews and meta-analysis, we are evaluating or analyzing
data from a variety of randomized controlled trials or a
variety of studies that were done on a specific topic.
A recent example is a systematic review that we have
published in the April edition of the Journal of the American
Dental Association.1 In this study we have evaluated and
analyzed randomized controlled trials comparing oscillating
rotating versus other powered toothbrushes. Our findings
showed that there is some evidence to suggest that oscillating
rotating toothbrushes might remove more plaque
and reduce the number of bleeding sites better than other
powered toothbrushes.
Oral-B iO
Recently, Oral-B has introduced a new oscillating rotating
electric toothbrush, the Oral-B iO (Figure 2), that combines
Oral-B’s round brush head with oscillation rotations and
micro-vibrations. Oral-B iO captures new design features
that are aimed to improve the patient’s experience of the
brush and encourage patient compliance.
WHAT DOES EVIDENCE SAY?
A recent supplement of the International Dental Journal3 provided several key studies that are representing the qualities of the new toothbrush. For example, in a randomized controlled study, designed to compare the Oral-B iO toothbrush to a manual toothbrush during an 8-week time period, it was reported that the odds ratio to transition from being a gingivitis patient to being a healthy patient after only 8 weeks were 14.5.4 This means, that the odds of transitioning from ‘not healthy’ (≥10% bleeding sites) at baseline to ‘healthy’ (<10% bleeding sites) gingivitis status at week 8 was 14.5 times higher when using the electric brush than when using the manual brush.
In another randomized controlled study that compared
the Oral-B iO to a sonic toothbrush during an 8-week
time period it was found that the odds ratio to transition
from being a gingivitis patient to being a healthy
patient after 8 weeks were 4.75.5 This means, again, that
the odds of transitioning from ‘not healthy’ at baseline
to ‘healthy’ at week 8 was 4.75 times higher when using
the novel OR brush than when using the sonic brush, a
highly significant difference.
Of course, this ties in very well to our main goal as dental
practitioners which is to prevent oral diseases and
promote oral health. This is the sometimes-forgotten
key for success in our profession.
To learn more about Evidence-based Dentistry and how to develop, critically evaluate
and implement scientific evidence into your day-to-day practice, and apply these
prinicples in making the right decisions when advising patients on effective self-care
in caries and periodontol disease prevention, watch the webinar on dentalcare.ca
Learn more about Oral-B iO
References:
1. Clark-Perry D, Levin L. Systematic review and meta-analysis of randomized controlled studies comparing oscillating-rotating and other
powered toothbrushes. J Am Dent Assoc. 2020;151(4):265-275; 2. Grender J, Adam R, Zou Y. The effects of oscillating-rotating electric
toothbrushes on plaque and gingival health: A meta-analysis. Am J Dent. 2020;33(1):3-11; 3. Int Dent J. 2020;70 Suppl 1; 4. Grender J, Ram
Goyal C, Qaqish J, Adam R. An 8-week randomized controlled trial comparing the effect of a novel oscillating-rotating toothbrush versus a
manual toothbrush on plaque and gingivitis. Int Dent J. 2020;70 Suppl 1:S7-S15; 5. Adam R, Ram Goyal C, Qaqish J, Grender J. Evaluation of
an oscillating-rotating toothbrush with micro-vibrations versus a sonic toothbrush for the reduction of plaque and gingivitis: results from a
randomized controlled trial. Int Dent J. 2020;70 Suppl 1:S16-S21.
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