Effects of Manual and Powered Tooth Brushing on Biofilm Formation on Orthodontic Brackets and on Gingival Health

Background: Oral hygiene maintenance is significantly challenged in patients undergoing fixed orthodontic therapy due to increased plaque retention around brackets and wires. Biofilm accumulation on orthodontic brackets can lead to gingival inflammation and decalcification. This study aimed to evaluate and compare the effectiveness of manual and powered tooth brushing in reducing biofilm formation on orthodontic brackets and improving gingival health. Materials and Methods: A total of 40 orthodontic patients aged between 15 and 25 years were enrolled and randomly divided into two groups: Group A used manual toothbrushes and Group B used powered toothbrushes. The study duration was 4 weeks. The Plaque Index (PI), Gingival Index (GI), and Bracket Biofilm Score (BBS) were assessed at baseline and after 4 weeks. Standardized oral hygiene instructions were given to both groups, and compliance was monitored weekly. Results: Both groups demonstrated a reduction in plaque and gingival inflammation scores after 4 weeks. Group A (manual brushing) showed a decrease in PI from 2.4 ± 0.3 to 1.6 ± 0.4, and GI from 2.2 ± 0.2 to 1.5 ± 0.3. Group B (powered brushing) exhibited a greater reduction in PI from 2.5 ± 0.4 to 1.1 ± 0.2, and GI from 2.3 ± 0.3 to 1.0 ± 0.2. The BBS was significantly lower in Group B compared to Group A at the end of the study (0.9 ± 0.2 vs. 1.4 ± 0.3, p < 0.05). Conclusion: Powered tooth brushing was more effective than manual brushing in reducing biofilm accumulation around orthodontic brackets and improving gingival health. Its use should be encouraged in orthodontic patients to promote better oral hygiene outcomes.