Improved maintenance of plaque control by electrical toothbrushing in periodontitis patients with low compliance

Patients showing low compliance with oral hygiene were selected from a population of patients referred for specialist treatment of periodontitis. The patients selected did not show an acceptable plaque control in spite of a prolonged training period. Plaque around 40% of the tooth surfaces, documented over a period of 4 to 40 months of frequent information and instructions, was found in 10 patients around the age of 40 years with a marked overrepresentation of men. Substitution of the ordinary toothbrush with an electrical toothbrush using the same working principles, resulted in a decreased plaque score of approximately 10% maintained over a considerable time period (12-36 months). A common complaint among the patients was that the oral hygiene procedures were time-consuming and cumbersome. They considered the electrical toothbrush as simple and time saving. Even if these possibilities were not investigated, merely the patients' positive attitude may have made the efforts of tooth cleaning including the proximal cleaning more tolerable, thus improving the compliance. Contributing to the improved compliance might also have been the electrical toothbrush per se. The cleaning technique allows the patient to concentrate on aiming the bristles at the gingival sulcus, while the brush makes the movements. In conclusion, it should be worthwhile recommending an electrical toothbrush with simple working technique to low compliant periodontitis patients restricting the recalls to twice a year.