Background: This study aims to investigate the effect of various oral hygiene strategies on the symptoms of inflammation in neuromuscularly disabled patients and to define the optimum hygiene method.Methods: Fifty-nine neuromuscularly disabled participants, suffering from cerebral palsy, were randomly divided into five groups as follows: Group M: manual toothbrush (n=14), Group E: electrically powered toothbrush (n=9), Group MC: manual toothbrush and chlorhexidine gluconate (CHX) spray (n=13), Group EC: electrically powered toothbrush and CHX spray (n=9), and Group C: CHX spray (n=14). The oral hygiene applications were provided by the parents and staff. At baseline and after 21 days the plaque index (PI), the gingival index (GI), and bleeding on probing (BOP) were recorded. Results:In intra-group comparisons of the pre-and post-application scores, in all groups the PI and GI scores and BOP percentages, except in Group C, were found significantly different (p<0.05). There were significant differences among the post-application scores, between Group M and Group E and between Group C and Group E in PI scores; between Group C and Group E the difference in GI scores were found statistically significant (p<0.05). Conclusions:Although all oral hygiene strategies reduced plaque and gingival inflammation, the results of our study suggested the electrically powered toothbrush could be more recommendable to neuromuscularly disabled people in these strategies, while the combined procedures appeared to be neither beneficial nor favorable.

These results indicate that both CHX and CHX/B-HCl sprays have equal clinical effectiveness, but only B-HCl spray has less anti-plaque and anti-gingivitis effects. Furthermore, CHX/B-HCl spray causes more side effects.