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CURRENT RESEARCH DISCOVER THE BENEFITS OF SONIC TECHNOLOGY

Research

26 Jan 2017

Dr. Xavier Calvo,

Suitable for everyone, especially for those with various difficulties in carrying out conventional brushing, the electric brush has proven effective in removing dental biofilm, favouring thorough oral hygiene.

Oral hygiene has accompanied humankind since the beginning of civilization. All eras and cultures have adopted tools to improve people’s oral hygiene, consequently enhancing their oral health and quality of life in general.

At the beginning of the 1960s, the electric toothbrush emerged as an alternative to traditional manual brushing methods, especially for people with limited manual dexterity.

An electric toothbrush is one that has a motor in its handle providing mechanical movement, to which a head is attached which performs the action of brushing the teeth(1).

METHOD OF ACTION

The method of action of electric brushes was initially based on a combination of horizontal and vertical movements, attempting to imitate the back and forth strokes of traditional brushing techniques.

In the mid-1980s and in the 1990s, new generations of electric brushes appeared that either applied a circular or rotary/oscillating movement with pulsations, or had heads that moved at a high frequency, known as sonic technology(2).

In sonic technology, the electric brush emits high-frequency acoustic vibrations (between 260-500 Hz) generated by the horizontal vibration of the filaments at a speed of between 16,000 and 45,000 strokes per minute, compared to 300 strokes per minute which a manual brush can manage during brushing.

Sonic brushes have two cleaning mechanisms: one is mechanical, and the other is based on sonic technology:

  • Mechanical cleaning. This is the main action. Cleaning is accomplished thanks to the mechanical action performed by the filaments, which vibrate at a high frequency on the surface of the teeth, helping to remove dental plaque, or biofilm.
  • Acoustic and hydrodynamic vibration. Due to the high speed at which the filaments vibrate, acoustic waves are sent out. These waves and the energy associated are transmitted through the saliva throughout the oral cavity, exerting pressure fields that disrupt the biofilm and prevent its adhesion, even beyond the reach of the filaments themselves. This action occurs even without direct contact between the brush filaments and the teeth, at a distance of up to three millimetres. In addition, because of the vibratory movement, certain amounts of air enter into the saliva, which causes the formation of tiny bubbles that are pushed towards the areas where the plaque builds up. These bubbles are rich in oxygen and when they reach the subgingival areas, which have little oxygen, they expose the anaerobic colonies to an increased oxygen concentration (an unfavourable medium for their growth). Fluid dynamics can alter dental plaque in hard-to-reach areas such as between the teeth or below the gum line(2).

Thus, the basic advantage of sonic brushing compared to other technologies is that it adds fluid dynamics to the action of conventional mechanical cleaning (friction).

This action helps to disrupt bacterial colonies and, in turn, inhibits their growth and development. By accessing hard-to-reach areas, it also helps to dilute and eliminate toxins produced by bacteria residing therein. Both actions help minimise the negative effects of oral biofilm.

INDICATIONS

Electric brushes are suitable for everyone, but continue to be particularly useful for people with limited capacity for carrying out proper oral hygiene, those who have difficulty mastering proper manual brushing technique, with limited manual dexterity (osteoarthritis, arthritis, etc.), the disabled, those lacking a dentist’s guidance or who lack motivation, the elderly, etc.

A multitude of studies have been carried out to evaluate the efficacy and safety of electric brushes in patients with certain specific conditions, such as those with periodontal disease, implants, orthodontics or disabilities, for whom the thorough removal of oral biofilm is essential to avoid possible complications. All these studies have shown this technology brings multiple benefits to patients’ daily oral hygiene.

Once patients with periodontal disease have been treated, success depends on many factors. One prerequisite for long-term periodontal treatment success is the patient’s ability to keep biofilm to a minimum.

And it is known that periodontal patients do not keep oral biofilm under proper control and are prone to relapse. One of the measures facilitating oral hygiene procedures is the use of electric brushes, as these patients require longer than normal brushing times, of between three and four minutes.

The role of electric brushes in periodontal therapy maintenance has been considered in several different clinical studies(3,4). These validate the efficacy and safety of the use of electric brushes by patients with periodontal disease.

Likewise, the build up of biofilm can cause complications in patients with dental implants and may lead to the development of peri-implant diseases (peri-implant mucositis and peri-implantitis). Electric brushes with sonic technology have proven to be safe in patients with fixed prostheses or implants(5,6).

Patients with fixed orthodontic appliances are also at greater risk of developing tooth decay and gingival inflammation, as brackets, arches, and other orthodontic appliances are structures that favour the build up of biofilm and compromise its proper removal, thereby impairing the oral hygiene of these patients.

Electric brushes with sonic technology have been shown to improve plaque levels and reduce gingival bleeding in patients with fixed orthodontics(7). Finally, they can also be an effective oral hygiene tool for patients with intellectual disability, as shown by a recently published study(8).  

CONCLUSION 

Sonic electric brushes are a valid option for everyone and have proven to be safe and effective in removing dental biofilm. In addition, they can potentially improve oral hygiene by enhancing brushing technique and increasing motivation.

INDICATIONS FOR THE SONIC ELECTRIC BRUSH

Indicated for everyone 

  • Those who are demanding with their daily oral hygiene 
  • Those with poor brushing technique 
  • Those with limited manual dexterity, etc. 
  • Specific situations: - Gum problems - Braces - Implants

About the Author

Periodontist and Medical Advisor at DENTAID

Bibliography

REFERENCES

(1) Cancro LP, Fischman SL. The expected effect on oral health of dental plaque control through mechanical removal. Periodontology 2000; 1995; vol. 8: 60-74.

(2) Himmer K, Eickholz P. Cepillos dentales eléctricos: visión global. Quintessence (ed. esp.), vol. 22, núm. 10, 2009: 450-461.

(3) Haffajee A, Thompson M, Torresyap G, Guerrero D, Socransky S. Efficacy of manual and powered toothbrushes (I). Effect on clinical parameters. J Clin Periodontol 2001; 28: 937-946.

(4) Roscher T, Rosing C, Gjermo P, Aass A. Effect of instruction and motivation in the use of electric and manual toothbrushes in periodontal patients. A comparative study. Braz Oral Res 2004; 18 (4): 296-300.

(5) Wolff L, Kim A, Nunn M, Bakdash B. Effectiveness of a sonic toothbrush in maintenance of dental implants. J Clin Periodontol 1998; 25: 821-828.

(6) Lee J, Lim JH, Lee J, y cols. Efficacy of sonic-powered toothbrushes for plaque removal in patients with peri-implant mucositis. Journal of Periodontal & Implant Science 2015; 45(2): 56-61. doi:10.5051/jpis.2015.45.2.56.

(7) Ho HP, Niederman R. Effectiveness of the Sonicare sonic toothbrush on reduction of plaque, gingivitis, probing pocket depth and supragingival bacteria in adolescent orthodontic patients. Journal of Clinical Dentistry 1997; 8: 15-19.

(8) García-Carrillo A, Jover A, Plá R, Martorell A, Sota C, Gómez-Moreno G, Figuero E, Sanz M, Herrera D. Manual versus sonic powered toothbrushing in patients with intellectual disability: a cluster-randomized clinical trial. J Clin Periodontol 2016; 43: 684-693.

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