Efficacy of bioelectric toothbrush in reducing gingival inflammation: a randomized controlled trial

Abstract Mechanical plaque control is the cornerstone of preventing plaque-induced gingivitis; however, conventional methods often fail to disrupt the protective extracellular polymeric substance (EPS) matrix of mature biofilms. Bioelectric (BE) technology, utilizing low-level microcurrents (50–200 μA), has emerged as an innovative approach to electrochemically weaken this matrix. In this 4-week randomized, examiner-blinded, parallel-group clinical trial, 99 systemically healthy adults with mild-to-moderate plaque-induced gingivitis were randomly assigned (n = 33 per group) to a BE, manual, or sonic toothbrush. All participants brushed twice daily using a standardized fluoride dentifrice. At week 4, the BE group achieved a significantly lower baseline-adjusted mean Gingival Index (GI) score (0.82) than the manual (1.41; P < 0.001) and sonic (1.08; P = 0.023) groups. For plaque control (adjusted Plaque Index [PI]), both the BE and sonic groups outperformed the manual group (P < 0.05), with no significant difference between the two powered toothbrushes. For bleeding on probing (adjusted %BOP), the BE group achieved a significantly lower score than the manual group (8.76% vs. 14.30%; P = 0.033). No adverse events were reported. The bioelectric toothbrush significantly improved gingival inflammation compared with both manual and sonic toothbrushes, demonstrated plaque-control efficacy comparable to sonic toothbrushing, and achieved greater reductions in bleeding on probing than manual toothbrushing.