Work

Single vs Triple-Headed Toothbrushes in Children With Special Needs: A Randomised Crossover Trial of Brushing Efficacy

Year: 2026

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: INTRODUCTION AND AIMS: Children with special needs (CSN) often struggle with effective toothbrushing, which is attributed to factors such as toothbrush type and visual-motor integration (VMI). This study aimed to compare the brushing efficacy of single-headed toothbrushes (SHT) vs triple-headed toothbrushes (THT) at varying VMI levels. METHODS: This single-blind, randomised controlled crossover study involved 46 CSN ranging in age from 6.1 to 12.0 years. Baseline plaque index (PI), gingival index (GI), and VMI levels were measured. Participants were assigned a toothbrush type using block randomisation and received oral hygiene instructions accordingly. After participants completed self-brushing, immediate post-brushing PI, brushing durations, and brushing performance were assessed. Following a 1-month washout period, the process was repeated using the alternate toothbrush type. A t-test statistical analysis of 2 × 2 crossover design was utilised. RESULTS: THT use resulted in significantly lower post-brushing PI and a greater percentage of plaque reduction (P < .001). Within similar VMI levels, THT showed significantly better plaque removal than SHT in both normal (P = .02) and impaired (P = .009) VMI groups. However, there was no statistically significant difference between VMI levels. Additionally, THT required less brushing time (2.3 ± 0.9 vs 3.3 ± 0.9 minutes, P < .001) and provided superior cleaning on lingual surfaces across all tooth areas (P < .001-.041), except for the first permanent molars. CONCLUSION: THT demonstrated superior plaque removal and reduced brushing time in CSN, regardless of VMI level. It also enhanced cleaning of difficult-to-reach lingual/palatal surfaces, although its efficacy was comparable to SHT in the first permanent molar areas. CLINICAL RELEVANCE: For CSN who brush independently, the use of THT may improve oral hygiene and reduce the burden on caregivers. Dental professionals should consider recommending THT for this cohort.

Source: International Dental Journal

DOI: 10.1016/j.identj.2025.109388

Authors: Thanapon Tanaiadchawoot, Apiwan Smutkeeree, Sudaporn Khamduangdao, Pornpailin Kasemkhun

Institutions: Mahidol University, Ministry of Public Health, Rajanagarindra Institute of Child and Adolescent Mental Health

Language: English

Topic: Dental Health and Care Utilization

Subfield: Periodontics

Field: Dentistry

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,550