Efficacy of manual, musical and electric toothbrushes in plaque removal in children—a randomized clinical trial

Background: Tooth brushing is essential for oral hygiene in children, promoting plaque removal and preventing periodontal diseases. This study aimed to evaluate and compare the effectiveness of manual, musical and electric toothbrushes in removing supragingival plaque in children aged 6–12 years. Methods: A single-blind, randomized study enrolled 111 children aged 6–12 years who met the inclusion criteria. Participants were randomly assigned to three groups: group 1 (manual toothbrush), group 2 (musical toothbrush) and group 3 (electric toothbrush). They were instructed to brush their teeth twice daily for 2 minutes over a 45-day period. Plaque levels were assessed using the Quigley-Hein plaque index (PI) at baseline (day 0) and after 15, 30 and 45 days following 24 hours of no oral hygiene. At each visit, plaque removal was evaluated using a disclosing solution before and after supervised brushing. Statistical analyses included one-way Analysis of variance formula and paired t-tests to compare plaque scores within and between groups. Results: Intragroup comparisons showed significant plaque reduction from pre- to post-brushing at all time points for all groups, except group 3 on day 45, where the reduction was not statistically significant (p = 0.083). Intergroup analyses indicated variations in plaque removal efficacy, with electric and musical toothbrushes generally demonstrating greater plaque removal than manual toothbrushes, particularly at earlier follow-up visits. However, some differences were not statistically significant. Conclusions: Musical and electric toothbrushes were more effective than manual toothbrushes in reducing plaque in children aged 6–12 years. These findings support the use of interactive toothbrushes as effective tools for improving pediatric oral hygiene. Further research is needed to control for dietary habits and brushing adherence. Clinical Trial Registration: This study is registered with ClinicalTrials.gov in the United States (Reference No: NCT06541743).

Children; Oral health; Toothbrushing; Dental plaque

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