Comparative Evaluation of Plaque Removal Efficiency of Electric, Manual, and Sonic Toothbrushes in Children Aged 6 To 12 Years: A Randomized Controlled Trial

Background: Maintaining good oral hygiene in children is crucial for preventing dental caries and gum diseases. Effective plaque removal plays a key role in ensuring optimal oral health, and the type of toothbrush used can significantly influence plaque control. Although manual toothbrushes remain widely used, electric and sonic toothbrushes have gained popularity due to their advanced cleaning mechanisms. However, limited research has compared the effectiveness of these toothbrush types in younger children. Aim: To assess and compare the plaque removal efficacy of manual, electric, and sonic toothbrushes in children aged 6 to 12 years. Materials and Methods: A randomized controlled trial was conducted among 78 children, categorized into three groups: manual, electric, and sonic toothbrush users. All participants followed the Bass brushing technique for two minutes under supervision. Plaque Index (PI), Patient Hygiene Performance (PHP) Index, and Decayed, Missing, and Filled Teeth (DMFT) Index were measured at baseline, 3 months, and 6 months. Anxiety levels were evaluated using Ayesha’s Oddbods Anxiety Scale. Data analysis was carried out using SPSS software version 27. Results: The manual toothbrush group showed a significant increase in GI (0.35 ± 0.485 to 2.42 ± 0.504 at 3 months) and DMFT (0.62 ± 0.571 to 4.27 ± 2.164 at 3 months), with slight improvement at 6 months (GI: 2.54 ± 0.508, DMFT: 3.46 ± 0.508). The electric toothbrush group demonstrated better plaque control, with GI improving from 1.65 ± 0.485 to 2.46 ± 0.508 and DMFT reducing from 2.50 ± 0.510 to 1.23 ± 0.430 at 6 months. The sonic toothbrush group showed the most significant improvements, with GI decreasing from 1.88 ± 0.653 to 1.50 ± 0.510 and DMFT from 2.50 ± 0.510 to 1.23 ± 0.430 at 6 months. Anxiety levels significantly decreased in the sonic toothbrush group (36.65 ± 7.725 to 22.04 ± 4.521). Statistical analysis (Repeated Measures ANOVA, effect size analysis and Paired t test) confirmed significant differences (p < 0.05) among groups, demonstrating the superior effectiveness of electric and sonic toothbrushes. Conclusion: Electric and sonic toothbrushes proved more effective than manual toothbrushes in enhancing oral health. Additionally, sonic toothbrushes offered the added benefit of reducing dental anxiety in children.