The long-term effect on oral health and quality of life using a powered toothbrush in individuals with mild cognitive impairment. An intervention trial.

BACKGROUND: The number of older individuals with mild cognitive impairment and neurocognitive diseases is increasing, which may rapidly deteriorate oral health and Quality of life. Therefore, removing dental biofilm is essential for maintaining good oral health. The present study aimed to investigate whether introducing a powered toothbrush reduces the presence of dental plaque, bleeding on probing, and periodontal pockets ≥4 mm, leading to maintained or improved oral health and improved Quality of life in a group of older individuals with mild cognitive impairment. METHODS: Two hundred and thirteen individuals aged 55 or older living without official home care with a Mini-Mental State Examination (MMSE) score between 20 and 28 and a history of memory problems in the previous 6 months were recruited and screened for the study. The individuals received a powered toothbrush and thorough instructions on how to use it. Clinical oral examinations, Quality of life examinations, and MMSE tests were conducted at baseline, 6, 12, and 24 months. The intervention group was compared to control groups at baseline and 24-month examination. It was divided into an MMSE high group with a score of more than 26 and an MMSE low group with a score of 26 and lower or decreasing two steps or more for 12 months. RESULTS: PI, BOP, and PPD≥4 mm improved continuously in both MMSE groups during the 24 months of the study. The values for QoL-AD deteriorated over time, while the oral health-related Quality of life did not show any statistically significant changes. CONCLUSIONS: Introducing a powered toothbrush improved PI, BOP, and PPD≥4 mm over 24 months, even among individuals with low or declining MMSE scores. Improved oral health is associated with a preserved OHR-QoL.

Results of objective brushing data recorded from a powered toothbrush used by elderly individuals with mild cognitive impairment related to values for oral health.

OBJECTIVES: The study aimed to investigate how the objective use of a powered toothbrush in frequency and duration affects plaque index, bleeding on probing, and periodontal pocket depth ≥ 4 mm in elderly individuals with MCI. A second aim was to compare the objective results with the participants' self-estimated brush use. MATERIALS AND METHODS: Objective brush usage data was extracted from the participants' powered toothbrushes and related to the oral health variables plaque index, bleeding on probing, and periodontal pocket depth ≥ 4 mm. Furthermore, the objective usage data was compared with the participants' self-reported brush usage reported in a questionnaire at baseline and 6- and 12-month examination. RESULTS: Out of a screened sample of 213 individuals, 170 fulfilled the 12-month visit. The principal findings are that despite the objective values registered for frequency and duration being lower than the recommended and less than the instructed, using powered toothbrushes after instruction and information led to improved values for PI, BOP, and PPD ≥ 4 mm in the group of elderly with MIC. CONCLUSIONS: Despite lower brush frequency and duration than the generally recommended, using a powered toothbrush improved oral health. The objective brush data recorded from the powered toothbrush correlates poorly with the self-estimated brush use. CLINICAL RELEVANCE: Using objective brush data can become one of the factors in the collaboration to preserve and improve oral health in older people with mild cognitive impairment. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05941611, retrospectively registered 11/07/2023.

Use of a powered toothbrush to improve oral health in individuals with mild cognitive impairment.

OBJECTIVES: The aim of the study is to investigate whether the use of a powered toothbrush could maintain oral health by reducing the dental plaque (PI), bleeding on probing (BOP), and periodontal pocket depth (PPD) ≥4 mm in a group of individuals with MCI and also if changes in oral health affect various aspects of quality of life. BACKGROUND: People with cognitive impairment tend to have poor oral hygiene and poorer Quality of life. In the present study, the participants were asked to use a powered toothbrush for at least 2 min morning and evening and no restrictions were given against the use of other oral care products. The participant survey conducted at each examination demonstrated that 61.2% of participants at baseline claimed to have experience of using a powered toothbrush, 95.4% at 6 months and 95% after 12 months. At the same time, the use of manual toothbrushes dropped from 73.3% to 44.7% from baseline to the 12-month check-up. This shows that several participants continue to use the manual toothbrush in parallel with the powered toothbrush, but that there is a shift towards increased use of the powered toothbrush. Removal of dental biofilm is essential for maintaining good oral health. We investigated whether using a powered toothbrush reduces the presence of dental plaque, bleeding on probing and periodontal pockets ≥4 mm in a group of older individuals with mild cognitive impairment. MATERIALS AND METHODS: Two hundred and thirteen individuals with the mean age of 75.3 years living without official home care and with a Mini-Mental State Examination (MMSE) score between 20 and 28 and a history of memory problems in the previous six months were recruited from the Swedish site of a multicenter project, Support Monitoring And Reminder Technology for Mild Dementia (SMART4MD) and screened for the study. The individuals received a powered toothbrush and thorough instructions on how to use it. Clinical oral examinations and MMSE tests were conducted at baseline, 6 and 12 months. RESULTS: One hundred seventy participants, 36.5% women and 63.5% men, completed a 12-month follow-up. The use of a powered toothbrush resulted, for the entire group, in a significant decrease in plaque index from 41% at baseline to 31.5% after 12 months (P < .000). Within the same time frame, the values for bleeding on probing changed from 15.1% to 9.9% (P < .000) and the percentage of probing pocket depths ≥4 mm from 11.5% to 8.2% (P < .004). The observed improvements in the Oral Health Impact Profile 14 correlate with the clinical improvements of oral health. CONCLUSION: The use of a powered toothbrush was associated with a reduction of PI, BOP and PPD over 12 months even among individuals with low or declining MMSE score. An adequately used powered toothbrush maintain factors that affect oral health and oral health-related Quality of Life in people with mild cognitive impairment.