title: Toothbrushing education via a smart software visualization system.
abstract: BACKGROUND
  The aim of this study is to evaluate the efficiency of a recently developed smart digital toothbrush monitoring and training system (DTS) in terms of correct brushing motion and grip axis orientation in an at-home environment.
  
  
  METHODS
  Twenty-one participants (11 test individuals [DTSG] and 10 control individuals [COG]) received instructions on the modified Bass technique (MBT) after their toothbrushing performance was monitored and they received professional tooth cleaning (T0). After 36 hours (T1), without mechanical oral hygiene measures, plaque and gingival indices were recorded, and the brushing technique was reviewed. After randomization, participants individually performed oral hygiene for 6 weeks (T2) with the provided oral hygiene kits. The DTSG group additionally used DTS. During the following 8 weeks (T3), participants used their original brushing devices without any additional interference. Investigators at each visit were masked regarding group identity. Data were statistically evaluated using Mann-Whitney U, Friedman, Wilcoxon, and paired tests and Pearson correlation.
  
  
  RESULTS
  At T0, 27.27% of DTSG participants used the MBT correctly (COG, 50%), increasing to 54.55% (COG, 60%) after professional instruction (T1) and further to 90.91% at T2 (COG, 60%) (P <0.001). Plaque scores were reduced in DTSG (P <0.05). At T3, 80% of the DTSG (COG, 40%) totally adopted the MBT (P <0.05). The plaque scores on buccal surfaces of the DTSG showed an additional slight improvement between T2 and T3, in contrast to a decline on oral surfaces (P <0.001). At T2 and T3, the DTSG brushed >120 seconds (COG, 90% and 50%) (P <0.05).
  
  
  CONCLUSIONS
  Apparently, the tested DTS effectively improves the brushing technique and leads to a prolonged learning effect, including improved oral hygiene.
authors.affiliation: Clinic of Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany. graetz@konspar.uni-kiel.de
authors.forename: Christian
authors.initials: C
authors.lastname: Graetz
authors.forename: Jule
authors.initials: J
authors.lastname: Bielfeldt
authors.forename: Lars
authors.initials: L
authors.lastname: Wolff
authors.forename: Claudia
authors.initials: C
authors.lastname: Springer
authors.forename: Karim M Fawzy
authors.initials: KM
authors.lastname: El-Sayed
authors.forename: Sonja
authors.initials: S
authors.lastname: Sälzer
authors.forename: Sabah
authors.initials: S
authors.lastname: Badri-Höher
authors.forename: Christof E
authors.initials: CE
authors.lastname: Dörfer
mesh_terms: D000293:Adolescent; D000328:Adult; D003774:Dental Plaque Index; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000293:injuries; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D010512:Periodontal Index; D010865:Pilot Projects; D011446:Prospective Studies; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation; D016037:Single-Blind Method; D012984:Software; D013663:Teaching / Q000379:methods*; D013997:Time Factors; D014099:Toothbrushing / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D055815:Young Adult