Effects of Professional Toothbrushing and Instruction in the Elderly: A Randomized Trial

Abstract

The purpose of this study was to identify the effect of providing toothbrushing by professionals as part of oral hygiene education for the elderly. We randomly visited 12 centers in the metropolitan city and analyzed the data of 114 participants among 310 early registrants aged ＞65 years, who participated in the study at all 3 time points. The subjects were categorized into an experimental group (odd-numbered visits) and a control group (even-numbered visits). Oral hygiene practices were provided for both experimental and control groups, but professional toothbrushing was performed in a different manner in the experimental group. Differences in plaque index (PI) according to the subjects' general characteristics and oral health status were assessed using the t-test, and the effect of PI difference between the experimental and control groups was assessed by repeated measure two-way analysis of variance. A stepwise multiple regression analysis was used to analyze factors affecting the PI. At baseline, the mean overall PI was 61.82. In both experimental and control groups, the PI significantly reduced from the baseline (p＜0.01). At 5 weeks, the experimental group showed a decrease of 27.16 points from the baseline, and the 10-week PI was similar to the 5-week PI. The control group showed a decrease of 14.87 points from the baseline, and the PI increased by 5.74 points at 10 weeks. PI-related factors were gender and self-xerostomia. The PI was lower in the female group and the group with self-xerostomia (p＜0.01). It is important to select an appropriate method to educate elderly subjects on proper removal of dental plaque and to habituate correct behavior, which requires inclusion of a direct toothbrushing intervention by a specialist.