Effectiveness of Oral Hygiene Aids for Children with Special Healthcare Needs: A Systematic Review and Meta-Analysis

Introduction Children with special healthcare needs (CSHCN) often experience substantial barriers to maintaining oral hygiene because of physical, sensory, cognitive, or behavioral limitations. Various oral hygiene aids have been developed to improve plaque control and facilitate daily oral care in this population. This systematic review and meta-analysis aimed to evaluate the clinical effectiveness and practical applicability of oral hygiene aids for children with special healthcare needs. Materials and Methods A systematic search of five databases (PubMed, Cochrane, Embase, Scopus, and Google Scholar) from 2006 to 2026 was conducted. Randomized controlled trials and clinical studies assessing oral hygiene aids in CSHCN were included. Risk of bias was assessed using RoB 2, MINORS, and the Newcastle–Ottawa Scale. Meta-analysis using a random-effects model calculated standardized mean differences (SMDs) for plaque indices. Certainty of evidence was assessed using GRADE. Results Fifteen studies were included in the systematic review, with 8 RCTs analyzed in the meta-analysis. The quantitative synthesis indicated a significant reduction in plaque accumulation following targeted interventions (pooled SMD = −1.87; 95% CI: −2.40 to −1.35). Subgroup analyses suggested that triple-headed toothbrushes appeared to provide a substantial effect (SMD = −3.86, I 2 = 0%), whereas children with Down syndrome experienced marked improvements (SMD = −4.03) using 3D-printed handles. Qualitatively, evidence suggests that oral hygiene devices may help accommodate motor deficits and support behavioral compliance. Discussion The effectiveness of oral hygiene aids appears to depend on the alignment between device design and the child’s functional limitations. Structurally modified toothbrushes and customized handles may provide additional benefits for children with motor or intellectual disabilities, whereas powered toothbrushes may be particularly advantageous for sensory-impaired populations. Conclusion Adapted oral hygiene aids may improve plaque control in selected groups of children with special healthcare needs. However, considerable heterogeneity, limited data for individual devices, and low certainty of evidence restrict direct comparisons and generalizability. Individualized device selection and caregiver support warrant evaluation in larger, longer-term trials.