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Dr. Liran Levin, DMD, FRCD(C), FIADT, FICD

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.
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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.

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WHAT DOES EVIDENCE SAY?
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advv215 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.
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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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